ASRA Pain Medicine has joined the American Society of Anesthesiologists, the International Pain & Spine Intervention Society, and the American Academy of Physical Medicine and Rehabilitation to speak out against BlueCross BlueShield of Massachusetts’ inclusion of several fascial plane blocks as investigational/non-covered services.

Representing the Pain Medicine Coalition, the four organizations explained in a letter that CPT codes 64466, 64467, 64468, 64469, 64473, and 64474, which describe thoracic and lower extremity fascial plane block procedures, underwent two years of rigorous vetting through the American Medical Association’s CPT and valuation processes prior to being included in the Medicare physician fee schedule. The procedure codes were added to the CPT Professional Manual in January 2025.

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These blocks are used to treat pain resulting from surgery, traumatic injury, or chronic diseases. They have been shown to reduce the need for opioids as part of a multimodal pain management regimen.

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The letter emphasized that the effectiveness of thoracic fascial plane blocks has been proven with the highest level of evidence, systematic reviews, and meta-analysis of randomized clinical trials, and they are associated with reduced pain intensity and decreased opioid consumption after various chest wall surgeries.

Lower extremity fascial plane blocks have been shown to decrease pain, opioid consumption and opioid-related complications through systematic reviews and meta-analysis.

The Pain Medicine Coalition represents more than 75,000 physicians dedicated to advancing evidence-based pain management. Its goal is to develop, monitor, and advocate for responsible health care policy for people who experience acute and chronic pain, and the physicians who support them. They accomplish this mission through clinical care, education addressing quality of care, access to care, public and professional education, and research.