Summary & Overview

CPT 0214T: Ultrasound-Guided Cervical/Thoracic Paravertebral Facet Joint Injection

CPT code 0214T denotes an ultrasound-guided injection of a diagnostic or therapeutic agent into an additional cervical or thoracic paravertebral facet joint or the nerves that exit the joint. This image-guided procedure is used for pain management or to deliver anesthetic prior to surgery and is significant nationally as a targeted, minimally invasive intervention within spine care and pain medicine. It is relevant to clinicians, facility billing staff, and payers because correct coding affects coverage determinations, site-of-service reporting, and claims adjudication.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and what to expect in payer coverage approaches. The publication provides benchmarks for utilization and reimbursement where available, notes applicable policy clarifications and prior authorization tendencies among major payers, and explains billing considerations specific to ultrasound-guided paravertebral facet joint or nerve injections. Data not available in the input is noted explicitly where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0214TCPTspine-injectionultrasound-guidedpain-managementfacet-joint-injectionoutpatient-procedure

Billing Code Overview

CPT code 0214T describes injection of a diagnostic or therapeutic agent under ultrasound guidance into an additional cervical or thoracic paravertebral facet joint or the nerves that exit the joint. The procedure may be performed to relieve pain or to administer an anesthetic for a surgical procedure.

Service type: Image-guided paravertebral facet joint or nerve injection (diagnostic or therapeutic)
Typical site of service: Outpatient surgical center or hospital outpatient setting; may also be performed in ambulatory procedure clinics or physician offices equipped for ultrasound-guided interventions.

Clinical & Coding Specifications

Clinical Context

A 54-year-old patient with chronic axial neck pain and facet-mediated radicular symptoms presents to an outpatient interventional pain clinic. After conservative care including oral analgesics, physical therapy, and a prior medial branch block with temporary relief, the physician schedules ultrasound-guided diagnostic/therapeutic paravertebral facet joint injection to the cervical or upper thoracic region to confirm the pain generator and to deliver corticosteroid and/or local anesthetic for symptom relief. The procedure is performed in an ambulatory surgical center or hospital outpatient department with continuous ultrasound imaging to identify the targeted facet joint or exiting nerve, sterile technique, and conscious sedation or local anesthesia as needed. The clinician documents indication, informed consent, targeted levels, laterality, medication(s) and volumes injected, imaging guidance as ultrasound, any intra-procedure complications, and post-procedure monitoring and discharge instructions. Typical workflow includes pre-procedure evaluation, time‑out, ultrasound localization, needle placement under direct visualization, injection of diagnostic and/or therapeutic agent, observation for recovery, and discharge with follow-up instructions for pain response and any procedural complications.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier — standard reporting	Use when no additional modifier is required for the service.
`23`	Unusual anesthesia	Use when general anesthesia is medically necessary and unusual for this procedure.
`50`	Bilateral procedure	Use when the injection is performed bilaterally during the same encounter.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to extenuating circumstances.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons during the procedure.
`66`	Surgical team	Use when a surgical team provides the service.
`78`	Return to OR for related procedure	Use when the patient returns to the operating room for a related procedure during the postoperative period.
`80`	Assistant surgeon	Use when an assistant surgeon is required and documented.
`81`	Minimum assistant surgeon	Use when a minimum assistant surgeon service is provided and documented.
`82`	Assistant surgeon (when qualified assistant unavailable)	Use when assistant surgeon services are provided by someone other than an approved assistant.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist	Use when an APP performs the service and payer requires this modifier.
`LT`	Left side	Use to indicate the left-sided injection.
`QX`	Ordering physician attestation modifier	Use when a physician assistant performs the service and the supervising physician identifier is reported with `QK`/`QY` or when payer requires the modifier pairing.

Taxonomy Code	Specialty	Notes
`2084P0800X`	Pain Medicine	Interventional pain specialists commonly perform cervical/thoracic facet injections.
`2084N0400X`	Anesthesiology	Anesthesiologists with pain fellowship training perform ultrasound-guided facet interventions.
`2084P0215X`	Physical Medicine & Rehabilitation	PM&R physicians perform diagnostic and therapeutic spinal injections.
`207RC0000X`	Radiology (Diagnostic)	Diagnostic radiologists or interventional radiologists perform image-guided spine injections.
`207LP2900X`	Neurology	Neurologists with interventional training may perform selected spine injections.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M54.2`	Cervicalgia	Common indication for cervical facet joint diagnostic/therapeutic injections to localize and treat neck pain.
`M54.3`	Sciatica	While primarily lumbar, thoracic radicular pain presentations may prompt facet or paravertebral nerve injections when clinically indicated.
`M53.3`	Sacrococcygeal disorders, not elsewhere classified	Included for regional spine pain patterns; less commonly directly targeted by cervical/thoracic facet injections.
`M40.0`	Postural kyphosis	Spinal deformity that can contribute to facet joint degeneration and pain leading to injection therapy.
`M48.02`	Spinal stenosis, cervical region	Cervical facet arthropathy and associated stenosis may be associated with axial and radicular pain treated with injections.
`M50.12`	Other cervical disc displacement, mid-cervical region	Cervical disc disease coexists with facet-mediated pain and may be evaluated/treated in the same diagnostic pathway.
`G54.1`	Brachial plexus disorders	Radicular-type upper extremity pain may overlap with cervical facet pathology prompting targeted injections.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0210T`	Injection(s), diagnostic or therapeutic agent, paravertebral facet joint (or nerves exiting the facet joint), cervical or thoracic, with image guidance (first level)	Represents the primary or first-level cervical/thoracic paravertebral facet injection often used for initial targeted level; `0214T` reports an additional level.
`0211T`	Injection(s), diagnostic or therapeutic agent, paravertebral facet joint (or nerves exiting the facet joint), cervical or thoracic, with image guidance (each additional level)	Used for subsequent additional levels performed at the same encounter; `0214T` is another additional-level code in the series.
`64490`	Injection, diagnostic or therapeutic agent, paravertebral facet joint or nerve, cervical or thoracic, single level, with imaging guidance	An alternative CPT coding pathway for facet joint or medial branch injections depending on payer policy; may be billed when payer does not recognize category III codes.
`77002`	Fluoroscopic guidance for needle placement (real-time)	Performed when fluoroscopy is used instead of ultrasound; documents imaging guidance adjunct to the injection.
`99152`	Moderate sedation services (procedural), initial 15 minutes	Billed when moderate sedation is provided and documented during the injection procedure.