Are the coverage recommendations publicly available?

Are the coverage recommendations determined in-house, or is there a contract with a third-party company?

Is there any symptom criteria?

Is there a minimum pain level (as determined by visual analog score)?

Is a physical examination or are physical examination findings needed?

Are there any specific magnetic resonance imaging language requirements?

Does the patient need a documented advanced imaging read of at least moderate-severe stenosis?

Does the patient need a documented advanced imaging read of at least mild-moderate stenosis?

Does the insurer define acceptable conservative treatments?

Does the insurer define how many different modalities of conservative treatments are needed?

Does the insurer conflate physical therapy, chiropractic treatment, and osteopathic manipulative treatment?

Is physical therapy mandatory?

How long does the trial of physical therapy/conservative treatment need to be?

Is a home exercise program an acceptable modality of conservative treatment?

Are epidural injections an acceptable modality of conservative treatment?

Is there a required level of response to epidural treatment that would indicate coverage?