Cite as: Giam P. ASA & ASRA Pain Medicine: impacting the future together. ASRA Pain Medicine News 2026;51. https://doi.org/10.52211/asra050126.003.

The American Society of Anesthesiologists (ASA)’s mission is to advance the practice of anesthesiology and secure the future. I am especially optimistic about the bright future of our specialty, given the pipeline of outstanding young physicians entering anesthesiology. I have made it a focus of my presidency to encourage our young physicians to get involved in ASA and to ensure they are aware of all the resources we offer throughout every stage of their careers.

It is equally important for them to get involved in our subspecialty organizations. ASA is not an island, and side by side with our subspecialty colleagues like ASRA Pain Medicine, we are working hard together on the issues impacting our members now while preparing for a better future.

Our collaborative approach with ASRA Pain Medicine is integral to our success across many fronts, including advocacy, guideline development, educational offerings, leadership development, and more.

Here are a few key accomplishments from the past year.

ASA Committee Accomplishments

Members of ASRA Pain Medicine participate in our Committee on Pain Medicine. ASA published Guidance on the Safe Use of Ketamine Outside of Acute Pain Management and Procedural Sedation, a joint effort from the Committee on Trauma and Emergency Preparedness and the Committee on Pain Medicine.

The Committee on Pain Medicine has been active in advocacy with several payment programs released by the Centers for Medicare & Medicaid Services (CMS) Innovation Center—the WISeR (Wasteful and Inappropriate Service Reduction) program and the Ambulatory Specialty Model, low back pain cohort. The committee has also engaged in advocacy related to insurer coverage of pain medicine procedures as well as state-level initiatives advocating for physician-only treatment of chronic pain.

In addition, the ASA Practice Parameters Acute Pain Taskforce published the 2026 American Society of Anesthesiologists Practice Guideline on Perioperative Pain Management Using Local and Regional Analgesia for Cardiothoracic Surgeries, Mastectomy, and Abdominal Surgeries.

Leadership Development

An important aspect of developing the next generation of anesthesiologists is providing resources for leadership development. Recognizing the critical challenges physicians face as they transition from fellowship to independent practice, ASRA Pain Medicine, in partnership with ASA’s Committee on Pain Medicine and the Association of Pain Program Directors, launched a new professional development initiative called the Pain Medicine Innovation & Leadership Certificate.

Designed specifically for early-career pain specialists, this yearlong program offers a comprehensive educational toolkit that includes essential clinical and practice-management content. Through live and on-demand sessions, mentorship, and access to advanced procedural workshops, the program aims to strengthen and support participants’ professional practice capabilities as they begin their careers in pain medicine.

Pain Medicine Coalition

ASA and ASRA Pain Medicine are co-founders of the Pain Medicine Coalition (PMC). The coalition works to address issues in pain medicine, including government and commercial payer challenges such as prior authorization requirements, legislative and regulatory advocacy, and other matters affecting the pain community.

The PMC is actively advocating for fair payment practices for pain procedures, including sending a formal communication to Blue Cross Blue Shield of Massachusetts seeking fair coverage for fascial plane blocks. The PMC is also prioritizing advocacy around prior authorizations and their effect on pain physicians and patients.

ASA works closely with our state component societies to address nurse anesthetist advocacy efforts to expand into interventional pain, as well as related “pain management” and prescriptive authority initiatives. 

Advocacy

Medicare administrative contractors (MACs) have released proposed local coverage determinations (LCDs) addressing peripheral nerve blocks (PNBs) and procedures for chronic pain.

PNBs were deemed “not reasonable and necessary” and classified as “experimental and investigational.” ASA sent formal communication to the MACs urging them to rescind the ill-advised policy. ASA also worked with the Multispecialty Pain Workgroup on this initiative. We believe PNBs are medically necessary, evidence-based, and reduce reliance on opioids. ASA, along with the Pain Medicine Coalition, met with the MACs to discuss our concerns with the draft LCDs and is leading a congressional communication to CMS, urging the withdrawal of the draft LCD, highlighting the loss of the non-opioid pain relief option.

ASA has been active in Medicare and commercial payment coverage for a variety of pain procedures and treatments. ASA and ASRA Pain Medicine worked with the American Medical Association (AMA) on shared efforts to ensure AMA support for key payment and coverage issues. Several of ASA’s pain medicine physician members represent ASA at both the Current Procedural Terminology and Relative Value Scale Update committees .

ASA and ASRA Pain Medicine obtained new codes and payment for thoracic and lower extremity fascial plane blocks. The new codes became available for use on January 1, 2025. Our collaborative work also obtained new codes and payment for percutaneous image-guided lumbar decompression for lumbar spinal stenosis. The new codes became effective January 1, 2026.

ASA works closely with our state component societies to address nurse anesthetist advocacy efforts to expand into interventional pain, as well as related “pain management” and prescriptive authority initiatives. Performance of pain medicine procedures should be limited to physicians with appropriate education, training, and background. In 2025, ASA worked with the Oklahoma Society of Anesthesiologists to defeat legislation that would have authorized nurse anesthetists to practice interventional pain medicine. Also in 2025, ASA worked with the Wisconsin Society of Anesthesiologists to pass legislation establishing guardrails for nurses engaged in pain management practice.

Education

ASA appreciates the opportunity to work closely with ASRA Pain Medicine during the ANESTHESIOLOGY^® annual meetings. Last year in San Antonio, there were 26 regional anesthesia and pain sessions.

ASRA Pain Medicine presented two panels in San Antonio: “ASRA Pain Medicine Regional Anesthesia Symposium: Head, chest, limbs and spine: Contemporary regional anesthetic techniques in the era of ERAS (Enhanced Recovery After Surgery),” and “ASRA Pain Medicine Chronic Pain Symposium: Optimizing Perioperative Pain Management.” During the meeting, ASA honored Mark C. Bicket, MD, PhD, FASA, with the 2025 James E. Cottrell, MD, Presidential Scholar Award for his significant contributions in pain medicine.

ASA provides opportunities for ASRA Pain Medicine to promote pain medicine fellowships to ASA medical students and resident members at our annual meeting, further encouraging practice in the subspecialty.

Research

Another critically important area is research. Over the last 18 years, ASA’s Foundation for Anesthesia Education and Research (FAER) has awarded $7.63 million in grants for pain-related research—its most-funded area of investigation.

In addition, the Anesthesia Research Council, jointly funded by ASA, the International Anesthesia Research Society, and FAER, advances initiatives related to the future of academic anesthesiology and anesthesia research. Research areas include intraoperative anesthesia care, basis of consciousness, reduction of organ injury during transplantation, opioid sparing techniques, and interventional pain.

I am deeply optimistic about our shared future. With ASRA Pain Medicine by our side, we will continue to support our members with the resources they need to provide high-quality, safe patient care and to advance their careers. Together, we will continue to advocate for fair payment and the preservation of physician-led care. And together, we can advance the dream of helping our members practice medicine again for the joy of helping people.