Pain Management CPT Codes - Complete 2025 Billing Guide

Key Takeaways

  • Pain management CPT codes cover evaluation, injections, medications, ablations, and advanced procedures.
  • Common codes:
    • 99202–99215 = office visits
    • 99424–99425, G2002–G3003 = chronic pain management
    • 64490 = medial branch block
    • 64635 = RFA for lumbar/sacral facet joint
  • Injections include nerve blocks (64400–64425) and epidurals (62320–62327).
  • Medication management codes include 90688 (opioid), 90690 (non-opioid), and 91120 (NGF injections).
  • Documentation of medical necessity, lesion site, and technique is crucial.
  • Use modifiers (25, 59, 51) when appropriate to avoid denials.
  • Partnering with a medical billing company ensures accurate claims, compliance, and timely reimbursement.

Chronic pain is one of the most common reasons patients visit healthcare providers. From spinal injections to nerve ablations, pain management services require precise coding to avoid denials and ensure proper reimbursement.Β 

Because pain management CPT codes cover a wide range of evaluation, injections, and interventional procedures, accurate billing is essential for compliance and revenue cycle efficiency.

What are Pain Management CPT Codes?

Pain management CPT codes are medical billing codes that describe evaluations, injections, nerve blocks, ablations, and chronic care services to manage pain.Β 

These codes range from office visits (99202–99215) to advanced procedures like RFA (64635) and medial branch blocks (64490).

Key Pain Management CPT Codes (Detailed Explanation)

Evaluation & Management (E/M) Codes

Used for office visits, follow-ups, and chronic pain management planning.

Injection Codes

Applied for nerve blocks, epidural steroid injections, and peripheral nerve injections.

  • 64400–64425: Nerve blocks (e.g., trigeminal, stellate ganglion)
  • 62320–62327: Epidural steroid injections
  • 64450: Peripheral nerve blocks
  • 64490: Medial branch block, single level

Radiofrequency Ablation (RFA) Codes

Common for long-term pain relief in patients with spinal pain.

  • 64633–64636: Facet joint denervation (RFA)
  • 64635: Lumbar/sacral facet joint nerve ablation

Medication Management

  • 90688: Opioid pain medications
  • 90690: Non-opioid pain medications
  • 91120: Nerve growth factor (NGF) injections
  • Advanced Pain Procedures
  • 63650: Epidural neurostimulator implant
  • 64479: Dry needling
  • G2058: Additional chronic pain management services
  • 99487–99489: Complex chronic care management

Pain Management CPT Code Comparison Table

Category

CPT Codes

Examples

Evaluation

99202–99215

Office visits

Chronic Pain Mgmt

99424–99425, G2002–G3003

Ongoing care planning

Injections

64400–64450, 62320–62327

Nerve blocks, epidurals

RFA (Ablation)

64633–64636, 64635

Facet joint ablation

Medications

90688, 90690, 91120

Opioid/non-opioid injections

Advanced Procedures

63650, 64479

Stimulator implants, dry needling

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Conclusion

The pain management CPT codes are broad and evolving. Accurate coding ensures compliance with payer rules, supports fair reimbursement, and avoids denials. Since chronic pain patients often require multiple interventions, careful documentation of medical necessity and correct CPT selection are critical.

Cures Medical Billing helps pain specialists and interventional practices streamline billing, apply the right modifiers, and prevent costly errors.

Contact us today to improve your pain management billing and maximize reimbursements in 2025.

Frequently Asked Questions (FAQs)

The common CPT code for radiofrequency ablation (RFA) is 64635 for lumbar/sacral facet joint denervation.

Use 99424–99425 for chronic pain management visits. Medicare also uses G2002–G3003 for chronic pain care.

Yes. Depending on payer rules, modifiers (e.g., 25, 59, 51) may apply when procedures are performed together or alongside an E/M visit.

The most common pain management CPT codes include office visits (99202–99215), chronic pain management (99424–99425), epidural steroid injections (62320–62327), medial branch blocks (64490–64492), and radiofrequency ablation (64633–64636). These codes help providers document and bill accurately for both diagnostic and therapeutic pain procedures.

CPT 64635 is used for radiofrequency ablation (RFA) of lumbar or sacral facet joints, targeting one level. This procedure is typically performed to relieve chronic back pain caused by facet joint arthritis. If additional levels are treated, add-on code 64636 is reported.

CPT 64490 is for a medial branch block in the cervical or thoracic spine, usually performed for facet joint pain diagnosis and relief. In contrast, CPT 64450 covers a peripheral nerve block (other than the sciatic or femoral nerve) for localized pain outside the spinal region.

Yes. CPT 62320 is for an epidural steroid injection in the cervical or thoracic spine without imaging guidance, while CPT 62321 includes fluoroscopic or CT guidance. Both are used in pain management, but documentation of imaging is critical for correct coding.

Accurate documentation supports medical necessity, specifies the procedure site, laterality, and technique, and ensures correct modifier use. Without detailed notes, claims for pain management services like nerve blocks, RFA, or epidurals are more likely to face denials or underpayments.

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