Coverage of Conditions and Treatments (Coverage Decisions)

Use this lookup tool to determine coverage decisions, or if prior authorization is needed for the treatment or condition. Note: For Self-insured employer claims, you must contact the employer or their claims administrator.

List also available in PDF format.

Archived Coverage Decisions.

See Treatment Guidelines and Resources for additional information.

Vertebroplasty, kyphoplasty and sacroplasty are not covered for State Fund and Self-Insured workers’ compensation claims.

Health Technology Assessment Program Review

Vertebroplasty, kyphoplasty and sacroplasty are surgical interventions used to treat fractures of the bones in the spine (vertebrae).

On December 10, 2010, the State Health Technology Clinical Committee (HTCC) met to determine if the scientific evidence supports coverage of these treatments by state agencies. Based on a review of the best available evidence of the safety, effectiveness and value, the HTCC determined that vertebroplasty, kyphoplasty and sacroplasty are not covered for any condition. The decision was made final on March 18, 2011.

Complete information on this HTCC determination is available at:
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