TMPPM 2008 > Texas Medicaid Services > Physician > Procedures and Services

36.4.13 Epidural/Subarachnoid Infusion for Chronic Spasticity

Epidural/subarachnoid infusion of baclofen (Lioresal) for chronic spasticity is a benefit of the Texas Medicaid Program. Prior authorization is required for procedure codes 2-62350, 2-62360, 2-62361, and 2-62362.

Refer to: "Texas Medicaid Prior Authorization Request Form: Intrathecal Baclofen or Morphine Pump Sections I and II (2 Pages)" for guidelines.