Pain Medicine Coalition Meets With Medicare Contractors on Proposed Peripheral Nerve Block Coverage Limits
Leaders from the Pain Medicine Coalition (PMC) met virtually on January 15 with representatives from several Medicare Administrative Contractors (MACs) to discuss the proposed local coverage determination (LCD) affecting the use of peripheral nerve blocks (PNBs). The PMC is a joint advocacy effort established by ASRA Pain Medicine and the American Society of Anesthesiologists to provide responsible pain care for all patients.
During the meeting, physicians shared patient-centered examples illustrating the role of PNBs in managing complex pain conditions. These included occipital nerve blocks for patients with severe headache disorders, genicular nerve blocks and radiofrequency ablation for individuals with chronic knee pain seeking alternatives to corticosteroid injections or joint replacement, and stellate ganglion blocks for patients with post-herpetic neuralgia and upper-extremity complex regional pain syndrome.
Clinicians emphasized that, for many patients, these interventions support functional recovery and the ability to participate in daily life. They underscored the diagnostic value of PNBs in confirming pain generators and guiding further treatment decisions, noting that restrictions on these procedures could limit access to appropriate follow-up care.
“The proposed LCD will disrupt and significantly limit effective, non-opioid pain management options for many patients with significant pain,” said David Provenzano, immediate past president of ASRA Pain Medicine and PMC representative, who participated in the meeting. “It is important that MACs understand the long-term impact on patients and the broader effort to advance effective, non-opioid pain care.”
The discussion is part of ongoing efforts from the pain medicine community to support appropriate Medicare coverage of PNBs, including work that resulted in the AMA’s adoption of an ASRA Pain Medicine–led resolution opposing the proposed limits.
The PMC reiterated its commitment to working collaboratively with MACs to address concerns related to use and misuse while preserving access to medically necessary care. ASRA Pain Medicine will continue to keep members informed as the process moves forward.
Established in 2024, the PMC’s purpose is to advocate for policies and standards to ensure access to physician-led, high-quality pain care. They do this work through clinical care, education addressing quality of care, access to care, public and professional education, and research. Learn more about the PMC and all of ASRA Pain Medicine’s advocacy efforts at asra.com/advocacy.