Skip to main content
  • Find Care
  • Contact
  • Español
    Português
    English
  • Employers
  • Brokers
  • Providers
  • Blue Cross Blue Shield of Rhode Island
  • Individuals & Families
    Medicare
    Covered by Employers
  • Search
    Log in
    I am ...
    • A Medicare member
      A Medicare member
      A Medicare member
    • An individual & family member
    • A member covered by an employer
    • An employer
    • A provider
    • A broker

    New user?
    Register now

  • Overview
  • Shop
  • Why choose BCBSRI?
  • Insurance basics
  • Insurance through an employer?
  • Events
  • For Members
  • Member home
  • Your plan information
  • Doctors & hospitals
  • Discounts & savings
  • Supporting your health
  • Forms & resources
  • Caregiving

Is this for me?
If you buy insurance on your own, not through an employer, you'll learn how to choose, purchase, and get the most out of a plan for you and your family.

  • For Members
  • Member home
  • Your plan information
  • Doctors & hospitals
  • Discounts & savings
  • Supporting your health
  • Forms & resources
  • Caregiving

Is this for me?
If you purchase your health insurance through your employer, this section will show you how to make the most of your plan, from benefits to extra perks.

Blue Cross Blue Shield of Rhode Island
  • Individuals & Families
    • Overview
    • Shop
      • Shop
      • 2026 Medical coverage
      • 2026 Dental coverage
      • Find care
      • Eligible for special enrollment?
      • Travel health insurance
    • Why choose BCBSRI?
      • Network coverage
      • Pharmacy & prescriptions
      • What's included in all plans
      • Your Blue Store
      • Wellness programs
    • Insurance basics
      • How insurance works
      • How to choose
      • Sole proprietors
    • Insurance through an employer?
    • Events
    • For members
      • Member home
      • Your plan information
        • Your ID card
        • Your primary care
        • Do you need a referral?
        • Exclusive member perks
        • Billing & payments
        • Claims
        • Medical coverage
        • Dental coverage
        • Pediatric coverage
        • Pharmacy coverage
        • Health savings account
        • Change your plan
      • Doctors & hospitals
      • Discounts & savings
      • Managing your health
        • Care anytime you need it
        • Wellness & prevention
        • Maternal health
        • Chronic conditions
        • Cancer
        • Kidney disease
        • Mental health & substance use disorders
        • Safe Zones
      • Forms & resources
        • Forms
        • Look up a prescription
        • Definitions
        • FAQ
        • Important plan information
      • Caregiving
  • Medicare
  • Covered by employers
    • Employee home
    • Your plan information
      • Your ID card
      • Your primary care
      • Do you need a referral?
      • Exclusive member perks
      • Claims
      • Medical coverage
      • Pharmacy coverage
      • Dental coverage
      • Vision coverage
      • Travel health insurance
      • HRA/HSA/FSA
    • Doctors & hospitals
    • Discounts & savings
    • Managing your health
      • Care anytime you need it
      • Wellness & prevention
      • Maternal health
      • Chronic conditions
      • Cancer
      • Kidney disease
      • Mental health & substance use disorders
      • Safe Zones
    • Forms & resources
      • Forms
      • Look up a prescription
      • Definitions
      • FAQ
    • Caregiving
  • Employers
    • Overview
    • Explore plans
      • Medical plans
        • Plan types
        • Plan features
      • Integrated coverage
        • Pharmacy
        • Dental
        • Vision
        • Travel insurance
    • Programs & services
      • Care management
        • How care management works
        • Women's health
        • Behavioral health
        • Joint health
        • Cancer
        • Diabetes
        • Kidney disease
      • Wellness cash back rewards
        • 2-50 employees
        • 51+ employees
      • Enhanced member experience
        • BlueCare Connect
        • Employee Assistance Program
        • Doctor's Online 24/7
        • Blue365 member discounts
    • Leading change
      • Thinking ahead
        • Innovation & leadership
    • Resources
      • FAQs
      • Download plan information
      • Find the form you need
      • Visit Employer Toolkit
      • Group Activity Report (GAR)
  • Providers
    • Overview
    • Policies and coverage
      • Medical and Payment Policies
      • Pharmacy
      • Preauthorization
      • Preauthorization requirements
      • Preauthorization metrics
      • InterQual Criteria
    • Dental
    • Claims and eligibility
      • HIPAA transactions
      • How to file a claim
    • Secure portal
    • Provider Update
    • Member clinical programs
    • Forms
    • Doula application information
    • Become a participating provider
    • D-SNP Training
    • Safe Zone certification program
      • How to apply
      • Apply for certification
    • Contacts
    • FAQ
  • Brokers
  • Find Care
  • Contact
  • Log in
    • Medicare members
      Medicare members
      Medicare members
    • Individual & Family members
    • Members covered by an employer
    • Employers
    • Providers
    • Brokers
    • New user? Register now.
  • Español
    Português
    English
  • Facebook
  • LinkedIn
  • Instagram
  • Youtube

Providers Home

  • Providers

  • Policies and coverage
    • Medical policy development
    • Medical and payment policies lookup
    • Pharmacy
    • Preauthorization
    • Preauthorization requirements
    • Preauthorization metrics
    • InterQual criteria
  • Dental
  • Claims and eligibility
    • HIPAA transactions
    • How to file a claim
  • Secure portal
  • Provider Update
  • Member clinical programs
  • Forms
  • Doula application information
  • Become a participating provider
  • D-SNP Training
  • Safe Zone certification program
    • How to apply
    • Apply for certification
  • Contacts
  • CMS-0057-F Education
  • FAQ

Radiofrequency Ablation for Sacroiliac Joint Pain

Upload date
Oct 21, 2026
View PDF
Nov 3, 2025
View PDF
Apr 2, 2025
View PDF
Dec 4, 2024
View PDF
Jan 29, 2024
View PDF
Dec 21, 2023
View PDF
Feb 1, 2023
View PDF
Jul 18, 2022
View PDF
Nov 23, 2021
View PDF
Apr 8, 2021
View PDF
Oct 26, 2020
View PDF
Apr 12, 2020
View PDF
Dec 9, 2019
View PDF
Apr 8, 2019
View PDF

Back to all medical policies

  • What information are you looking for?

  • Individuals & Families
  • Medicare
  • Employers
  • Providers
  • Brokers

  • Company

  • About Us
  • Newsroom
  • Careers
  • Contact Us
  • Annual Report

  • Additional Help

  • COVID-19 Info
  • Find Care
  • The Rhode Ahead
  • Doctors Online

  • Legal Notices

  • Terms & Conditions
  • Privacy Statements
  • Surprise Billing Disclosure
  •

More ways to connect: Visit your nearest retail location or contact us.

  • Preauthorization Requirements
  • Developers
  • Accessibility Statement
  • Security & Fraud Prevention

We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex, including sexual orientation, gender identity, or gender expression. We also provide language assistance. Read our Nondiscrimination and Language Assistance notice.

Copyright © Blue Cross & Blue Shield of Rhode Island. All Rights Reserved.

All trademarks unless otherwise noted are the property of Blue Cross & Blue Shield of Rhode Island or the Blue Cross and Blue Shield Association. Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association.