Reimbursement / Pain Management

Interventional Spine

Boston Scientific annually updates and provides procedural coding and reimbursement information for inpatient, outpatient, office, and ASC settings.

Click on our guides to easily look up CPT codes, ICD-10 codes, physician RVUs, and Medicare national average reimbursement rates for Intracept.

Claim and Coding Information

Intracept

Last update: July 2025

BVNA 2025 Intracept Procedure Reimbursement Guide

Professional Intracept Claim Example

Medicare ASC Claim Example

Commercial ASC Outpatient Claim Example

Hospital Outpatient Claim Example

Documentation Best Practices

Dr. Marks (Medical Director) Best Documentation Practices Video

BVNA Documentation Best Practices Presentation

Intracept Patient Intake Form

Intracept Medical Necessity Card

MRI Addendum

BVNA Intracept Clinical Note

Intracept Documentation Best Practices Guide

Patient Access/Authorization Forms

Last update: Aug 2025

Patient Authorization Form Tear Pad

Patient Authorization Form Tear Pad Spanish

Patient Access Program Overview Brochure

Case Entry Overview Slides

FAQ

Last update: Aug 2025

MA Provider Complaint document

Veteran Community Care FAQ

Noridian Intracept LCD Customer Q&A

FAQs on BCBS MI and TP coverage policy changes

Payor Checklists

Last update: Nov 2025

Anthem/Carelon Intracept Coverage Criteria

BCBS Of Idaho Intracept Coverage Criteria

BCBS of Kansas Intracept Coverage Criteria

BCBS of Louisiana Intracept Coverage Criteria

BCBS of Massachusetts Intracept Coverage Criteria

BCBS of Michigan Intracept Coverage Criteria

BCBS of Minnesota Intracept Coverage Criteria

BCBS of Nebraska Intracept Coverage Criteria (Non-Portal Payor)

BCBS of North Carolina Intracept Coverage Criteria

BCBS of North Dakota Intracept Coverage Criteria (Non-Portal Payor)

BCBS of Rhode Island Medicare Advantage Coverage Criteria

BCBS of South Carolina Intracept Coverage Criteria

BCBS of Wyoming Intracept Coverage Criteria

CareSource Intracept Coverage Criteria

CareFirst BCBS Intracept Coverage Criteria

Cohere Commercial Intracept Coverage Criteria

Cohere Medicare Advantage Intracept Coverage Criteria

Connecticare Intracept Coverage Criteria (Non-Portal Payor)

Emblem Health Intracept Coverage Criteria (Non-Portal Payor)

GEHA Intracept Coverage Criteria (Non-Portal Payor)

Geisinger Intracept Coverage Criteria

HAP Intracept Coverage Criteria (Non-Portal Payor)

Harvard Pilgrim/Tufts Health Intracept Coverage Criteria

HCSC Intracept Coverage Criteria

Health New England Intracept Coverage Criteria

HealthPartners/Cohere Intracept Coverage Criteria

HealthPartners Self-Funded Intracept Coverage Criteria

Highmark BCBS Intracept Coverage Criteria (Non-Portal Payor)

Humana Medicare Advantage Intracept Coverage Criteria

Mass General Brigham Intracept Coverage Criteria

Medica/Carelon Intracept Coverage Criteria

Noridian Intracept Coverage Criteria (Non-Portal Payor)

NYS Worker’s Compensation Intracept Coverage Criteria (Non-Portal Payor)

Pacific Source Intracept Coverage Criteria (Non-Portal Payor)

Palmetto Intracept Coverage Criteria (Non-Portal Payor)

Paramount Intracept Coverage Criteria (Non-Portal Payor)

PHP Northern Indiana Intracept Coverage Criteria

PreferredOne Intracept Coverage Criteria (Non-Portal Payor)

Priority Health Intracept Coverage Criteria (Non-Portal Payor)

Providence Intracept Coverage Criteria (Non-Portal Payor)

PEHP Intracept Coverage Criteria

Select Health Intracept Coverage Criteria (Non-Portal Payor)

Tricare Intracept Coverage Criteria

Appointment of Representative (AOR) Forms

Last update: Oct 2025

Aetna Commercial AOR Form

Anthem DOR Form

Arkansas BCBS AOR Form

BCBS Alabama Appeals AOR Form

BCBS FEP AOR Form

BCBS Louisiana Appeals AOR Form

BCBS of VT Appeals AOR Form

Capital BCBS AOR Form

Cigna AOR Form

Emblem Health AOR Form

Empire BCBS AOR Form

Fidelis AOR Form

Florida Blue AOR Form

Harvard Pilgrim AOR Form

Horizon of NJ AOR Form

Humana Medicare AOR Form

Independence BCBS AOR Form

Mass General Brigham AOR Form

Medical Mutual AOR Form

Medicare Advantage Appointment of Representative Form

Oxford AOR Form

Tufts Health Plan AOR Form

UHC Commercial AOR Form

UPMC AOR Form

1199 SEIU AOR Form

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Resources

Find additional information on reimbursement, including summaries of CMS's annual rule updates for IPPS and OPPS

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