Medicare Administrative Contractors proposed to restrict Medicare coverage for most peripheral nerve blocks, related procedures for chronic pain

[Them Witches]

This move is showing evidence that Interventional Pain Management is not helping chronic pain patients in strong numbers. The goal for (IPM) is to remove chronic pain pateints's pain medications, full-agonists, and put them on Suboxone or give them only NSAIDS. For Medicare to step up like this is huge for giving cause to not remove established & stabilized chronic pain, chronic pain syndrome, and cancer patients from their helpful opioid/opiate pain medications. As most of us know, taking NSAIDS everyday all day long killing the liver, kidneys, and does not even touch "real" pain. Do not let these BS doctors mess you up and make your pain worse and ruin your quality of life.


References :

https://painmed.org/medicare-releases-proposed-lcd-on-peripheral-nerve-blocks/

Medicare Administrative Contractors Release Draft Policies Regarding Chronic Pain Procedures

In late 2025, several Medicare Administrative Contractors (MACs) issued proposed Local Coverage Determinations (LCDs) to severely restrict Medicare coverage for most peripheral nerve blocks (PNBs) and related procedures for chronic pain, limiting coverage to only a few specific injections (like for median neuropathy or Morton's neuroma) and radiofrequency ablation for trigeminal neuralgia, deeming many common procedures "not reasonable and necessary," sparking significant opposition and advocacy from pain management societies.
Key Changes in the Proposed LCDs:

• Significant Cuts: Most peripheral nerve blocks (e.g., occipital, genicular, stellate ganglion, suprascapular, pudendal) and denervation procedures would no longer be covered.
• Limited Coverage Remains:Coverage would potentially continue for:
  • Radiofrequency neurolysis for trigeminal neuralgia.
  • Corticosteroid injections for median neuropathy (carpal tunnel) at the wrist (max 3 per side).
  • Corticosteroid injections for Morton's neuroma (max 2 per side).

Who's Affected?

• Physicians (Interventional Pain Physicians, Physiatrists, Radiologists, Podiatrists) treating chronic pain.
• Patients relying on Medicare for access to these treatments, impacting common conditions like chronic headaches, back pain, and joint pain.

On September 25, several Medicare Administrative Contractors (MACs) released draft local coverage determinations (LCDs) describing proposed coverage for Peripheral Nerve Blocks and Procedures for Chronic Pain. The MACs, including CGS Administrators, National Government Services, Noridian Healthcare Solutions, and Palmetto GBA are accepting public comments through November 8 and WPS Insurance Corporation is accepting public comments through November 22.

The draft LCDs identify several procedures used by physiatrists and other physicians treating chronic pain as being “not reasonable and necessary.” Some procedures included on the list for noncoverage PM&R physicians provide include:

• Suprascapular nerve blocks
• Thoracic nerve blocks and denervation
• Genicular nerve blocks, cryoneurolysis, or ablation
• Pudendal nerve blocks

CMS recently released Proposed Local Coverage Determinations (LCDs) that address Peripheral Nerve Blocks and Procedures for Chronic Pain. These draft LCDs, issued by five out of seven Medicare Administrative Contractors (MACs), could significantly affect coverage for peripheral nerve ablation procedures, many of which now are deemed not medically necessary under the proposals.