Cigna to Cover Spinal Cord Stimulation for Diabetic Peripheral Neuropathy
Diabetic peripheral neuropathy is a covered condition by Medicare and many other insurers however, Cigna has incorporated into the new policy effective August 4, 2026 to cover diabetic peripheral neuropathy when all the criteria are met as follows:
Trial
A short-term trial (i.e., at least [5] days) of a non-high-frequency or high-frequency (HF10 SCS) dorsal column spinal cord stimulator is considered medically necessary when ALL of the following criteria have been met:
- Performed for the treatment of chronic, intractable pain secondary to diabetic peripheral neuropathy in the lower extremities
- Symptoms include BOTH of the following:
-
- lower extremity neuropathic pain present for >12 months
- pain is rated at least VAS ≥5
-
- Ineffective pain relief with or intolerance to at least TWO of the following:
-
- anticonvulsants
- tricyclic antidepressant
- SNRI (serotonin-norepinephrine reuptake inhibitor)
- opioids
-
- If taking opioids, the opioid use is ≤100MME (morphine milligram equivalent) per day.
- Hemoglobin A1c (HbA1c) <10% within three (3) months prior to trial
- There are no other medical diagnoses (e.g. chronic inflammatory demyelinating polyneuropathy [CIDP]; Hepatitis B; HIV; Lyme disease; chemotherapy or vitamin deficiency induced neuropathy) that are concordant with the presenting symptoms, signs, and results of relevant studies (e.g., imaging, electrodiagnostic testing, laboratory testing, etc.).
- Attestation by a behavioral health provider (i.e., a face-to-face or virtual assessment [with or without psychological questionnaires and/or psychological testing]) reveals no evidence of inadequately controlled mental and/or behavioral health conditions/issues (e.g., substance use disorders, depression, or psychosis) that would impact perception of pain, and/or negatively impact the success of a SCS or contraindicate placement of the device
Permanent Implant
Permanent implantation of a non-high-frequency or high-frequency (HF10 SCS) dorsal column spinal cord stimulator is considered medically necessary when BOTH of the following criteria have been met:
- Must meet ALL criteria for a short-term trial spinal cord stimulator as noted above.
- There has been documented pain relief of at least 50% during a short-term trial of SCS.
ASIPP Sends Letter Supporting H.R. 8163, the Provider Reimbursement Stability Act
The American Society of Interventional Pain Physicians has submitted a formal letter to Greg Murphy, MD, sponsor of H.R. 8163, the Provider Reimbursement Stability Act, expressing strong support for the legislation.
In the letter, ASIPP highlights ongoing concerns related to physician reimbursement and patient access to care, including:
• Declining reimbursement: Physician payment has decreased by 33% since 2001 when adjusted for inflation, with additional 2% sequestration cuts each year and looming 4% PAYGO cuts each year based on the Congressional Budget Office report.
• Rising practice costs: Medical inflation has significantly outpaced general inflation, with healthcare costs increasing by 121.3% compared to 86.1% for consumer goods and services. Practice costs have increased 56% from 2001 to 2025, while reimbursement has declined 33% overall and 41% for interventional pain physicians, with supply costs rising 78%.
• Access to care challenges: Current Medicare reimbursement policies are contributing to the closure of community-based practices, which is reducing patient access to high-quality interventional pain management services—particularly in the ambulatory surgery center (ASC) setting.
ASIPP emphasizes that H.R. 8163 would help stabilize physician reimbursement by modernizing Medicare payment policies, including increasing the budget neutrality threshold, indexing it to the Medicare Economic Index (MEI), and ensuring more frequent updates to practice expense inputs used in RVU calculations.
The letter underscores the importance of supporting independent physician practices to ensure continued access to high-quality, evidence-based pain care.
ASIPP: Why It Matters, What We Do, and How We Lead
Why was ASIPP created—and how has it evolved? This video explores the origin, early development, and history of ASIPP.
Aetna Now Covers Peripheral Nerve Stimulation for Chronic Pain
In a policy published by Aetna last week, entitled Peripheral Electrical Nerve Stimulation for Pain Number: 0011, Aetna describes the coverage conditions for peripherally implanted nerve stimulators as follows:
Aetna considers peripherally implanted nerve stimulators (e.g., Curonix Freedom PNS System, Nalu PNS System, SPRINT PNS System, StimRouter System) medically necessary DME for treatment of members with intractable neuropathic pain when all the following criteria are met.
a. Member has chronic intractable pain, refractory to other methods of treatment (e.g., analgesics and other medications (including TCAs, SSRIs, SNRIs and antiseizure medications, where appropriate), physical therapy (in-person for at least 6 weeks in the past year), local injection, surgery); and
b. Member is not addicted to drugs (per American Society of Addiction Medicine guidelines); and
c. There is no psychological contraindication to peripheral nerve stimulation; and
d. There is objective evidence of pathology (e.g., electromyography/nerve conduction studies and diagnostic blocks of the specific affected nerve(s)); and
e. Trial of percutaneous stimulation was successful (resulting in at least a 50% reduction in pain for a minimum of 3 days). Note: If a peripheral nerve stimulation trial fails, a repeat trial is not medically necessary unless there are extenuating circumstances that lead to trial failure. Trials will be limited to four leads with maximum of 16 contacts.
You can access the updated policy here: Aetna Policy
As you all know, ASIPP has been focused and working on coverage of peripheral nerve stimulators. Enclosed, please see the letter sent to HCSC Policy Review on October 7, 2025.
Humana to Cover Spinal Cord Stimulators for Non-Surgical Back Pain
After numerous attempts by various stakeholders, Humana has issued a policy covering spinal cord stimulators for non-surgical back pain. We are hoping that others will follow suit.
Please see the Humana Coverage Policy, along with ASIPPs letter to Humana related to spinal cord stimulators.
ASIPP Advocacy Update:
Recent Letters on Coverage and Physician Payment Policy
ASIPP recently submitted several letters on key issues affecting patient access to care and the sustainability of independent physician practices.
Clinical Input to Cigna on Peripheral Nerve Stimulation (PNS) Coverage
ASIPP submitted input to Cigna regarding their position on Peripheral Nerve Stimulation (PNS). The letter highlights current clinical evidence, peer-reviewed research, and ASIPP’s evidence-based guidelines supporting PNS as an established treatment option for appropriately selected patients with chronic pain.
ASIPP requested that Cigna reconsider the “not medically necessary” designation for Peripheral Nerve Stimulation, update Policy #0539 to reflect PNS as medically necessary for appropriate indications, and consider precedents from other payers such as Aetna, BCBS Alabama, and Medicare MACs.
Read the full letter:
https://asipp.org/letter-to-cigna-medical-policy-department-re-clinical-input-regarding-cignas-peripheral-nerve-stimulation-pns-medical-coverage-policy-0539-2-11-2026/
Coverage Consideration for the MILD Procedure for Lumbar Spinal Stenosis
ASIPP submitted letters to Elevance Health, Aetna, UnitedHealthcare, Humana, and Cigna supporting coverage for the MILD Procedure (Minimally Invasive Lumbar Decompression) for patients with lumbar spinal stenosis and neurogenic claudication. The letter highlights clinical evidence, FDA clearance, and real-world outcomes demonstrating the safety and effectiveness of this minimally invasive treatment option.
ASIPP also encouraged these payers to adopt favorable coverage policies aligned with newly approved Category I CPT codes effective January 1, 2026, to help ensure patient access to this evidence-based procedure.
Read the full letter:
https://asipp.org/letter-regarding-coverage-consideration-for-the-mild-procedure-for-lumbar-spinal-stenosis-with-neurogenic-claudication-2-25-2026/
Medicare Physician Fee Schedule and Impact on Independent Practices
ASIPP submitted a follow-up letter to The Honorable Chairman James Comer, Chairman, House Oversight Committee; The Honorable Chairman Brett Guthrie, Chairman, Energy and Commerce Health Subcommittee; Senator Bill Cassidy, MD, Chairman, Committee on Health, Education, Labor, and Pensions; The Honorable Chairman Mike Crapo, Chairman, Senate Finance Committee; and Senator Marsha Blackburn regarding concerns about the Medicare Physician Fee Schedule and its impact on independent physician practices.
The letter outlines several policy issues, including proposed reductions to practice expense reimbursement, the need to reinstate broader telehealth access, concerns regarding the Ambulatory Specialty Model (ASM), and the reversal of proposed efficiency cuts tied to assumptions about AI-driven documentation improvements.
ASIPP urged policymakers to examine these issues through hearings and policy review, noting the potential impact on physician reimbursement, patient access to care, and the stability of independent medical practices.
Read the full letter:
https://asipp.org/letter-regarding-follow-up-to-medicare-physician-fee-schedule-damages-independent-practices-letter-1-12-2026/
Telehealth services extended through December 2027
The House and Senate have both passed and the President signed the federal spending package, which includes HHS funding and an extension of telehealth services through December 2027.
This legislation is effective retroactively as of February 1, 2026. As a result, there is no lapse in telehealth coverage that would have otherwise occurred following the January 31, 2026, expiration under the continuing resolution. In addition, the continuing resolution has been extended for an additional two weeks and continues to include telehealth services. We have been advised that there will be no disruption in telehealth reimbursement, and that all claims will be paid retroactively.
Please see the enclosed document for the specific legislative language included in the bill.
Extension of the telehealth provisions has been one of the major focuses of ASIPP’s efforts. Over the past several months, we have worked closely with Chairman Guthrie, Chairman Comer, and Chairman Cassidy to advance this initiative. ASIPP is very pleased to have secured this outcome—while mid-term rather than permanent, the two-year extension provides important continuity and stability. The language remains unchanged, with the extension being the primary modification, as outlined in the enclosed text.
Thank you for your continued assistance and cooperation. We also extend our sincere appreciation to our congressional supporters who helped make this significant achievement possible.
Bibliometric Analysis of Musculoskeletal RFA Research Identifies Dr. Laxmaiah Manchikanti and Dr. Steven P. Cohen as Leading Authors, with Pain Physician and Pain Medicine Among the Most Influential Journals
A recent article in Pain Physician titled “Radiofrequency Ablation for Musculoskeletal Pain: A Bibliometric Analysis of Global Research Trends (2000–2024)” (Pain Physician 2025; 28:S157-S168) examines the research landscape surrounding radiofrequency ablation (RFA) for musculoskeletal pain. The analysis identifies Pain Physician as the most relevant journal in this field, with Pain Medicine ranked as the second most relevant source.
Key findings and related bibliometric rankings include:
- Laxmaiah Manchikanti
- Identified as one of the most influential authors based on sustained productivity and citation impact, with contributions shaping the evidence base for spinal and genicular nerve interventions (Pain Physician 2025; 28:S157-S168)
- Ranked #1 globally for randomized controlled trials in chronic pain therapy spanning 1989–2024 (Medicine, 2025; 104:39)
- Ranked #1 among the most cited studies on epidural steroid injections (PM&R Sciences, 2025; 292-297)
- Dr. Steven P. Cohen
- Recognized for high citation impact and influence in musculoskeletal RFA research (Pain Physician 2025; 28:S157-S168)
For detailed data, please refer to the full article:
https://www.painphysicianjournal.com/current/pdf?article=ODA5Mg%3D%3D
GABOR B. RACZ, MD, IN MEMORIAM
It is with profound sadness and a deep sense of loss that we share the passing of our beloved teacher, mentor, friend, and colleague, Gabor Bela Racz, MD, who passed away peacefully in his sleep in the early hours of June 21, 2025. Widely recognized as a Giant in pain management worldwide and awarded by the American Society of Interventional Pain Physicians (ASIPP) with this award, Dr. Racz’s contributions shaped the very foundation of our field.
Though he earned global acclaim, many of us remember him best as the long-serving Professor and Chair of Anesthesiology in Lubbock, Texas, where he trained hundreds of fellows and countless other physicians. He was an innovator at heart, pushing the boundaries of interventional pain medicine with vision and precision. I recall, even as early as 1982 when I began my anesthesiology practice, Dr. Racz had already pioneered the use of a spring, shear-resistant catheter to perform epidural injections in patients with epidural fibrosis—an innovation inspired by the kinking of an intravenous catheter in a pregnant patient. This eventually became the percutaneous epidural neuroplasty, known worldwide as the “Racz Procedure”, now performed hundreds of thousands of times across the globe.
His pioneering work extended beyond catheters and techniques. He applied this same catheter for intrathecal phenol injections for cancer pain and later combined it with hypertonic saline for adhesiolysis, further refining and standardizing these procedures.
Dr. Racz’s educational impact was equally far-reaching. Together with Dr. Prithvi Raj, he co-founded the World Institute of Pain (WIP), and the Annual Gabor Racz Pain Conference in Budapest stands as a testament to his enduring legacy.
He consistently emphasized that every procedure must be SAFE (safe, appropriate, fiscally responsible, and effective), he advanced multiple interventional techniques for both cancer and non-cancer pain, including early work in neuromodulation. Despite his towering influence across continents, it is humbling to remember that he began his life in Budapest (born 1937), fleeing Hungary during the 1956 Revolution with his beloved wife Enid, and later making the United States his home. He raised a loving family and found joy in the company of his children and grandchildren.
On a personal note, I first met Dr. Racz during a breakfast meeting—an encounter that led me to begin performing adhesiolysis. When I once faced a complication with a retained catheter, he personally guided me through the resolution. He had a gift for recognizing and encouraging original thinkers, and I was honored to receive the Trailblazer Award from him through WIP. I cherish the photographs from his visit to Paducah, KY, where he and Enid spent time with us, along with Drs. Prithvi and Susan Raj. These moments and memories hang proudly in my home and office.
Dr. Racz will be remembered not only for his unparalleled contributions to pain medicine but also for his compassion, mentorship, and enduring humanity. His absence leaves a void that will not be easily filled—but his legacy will live on through every life he touched and every procedure he refined.
While we miss him sorely, this is the time we can memorialize him. If you are interested in writing about him, please submit the manuscripts to Pain Physician. You will be waived the submitting fee.
Limits are as follows:
Abstract: Up to 250 words
Text: Maximum of 3,000 words
You can use pictures, references, etc. which are outside the limits.
Following Memoriam Provided by Standiford Helm, MD
Gabor Bela Racz, MD passed away peacefully in his sleep in the early hours of June 21, 2025. With his passing, we have lost one of the great figures of interventional pain management.
Dr. Racz was born and raised in Budapest. He left Budapest in the turbulent days of the 1956 Hungarian revolution with his wife of sixty-four years. One can still see the chip created in the building by a bullet intended for him.
Dr. Racz was able to make his way to England, where he completed his medical education and played on the English national water polo team. He was able to emigrate to the United States, where he started his academic career at Syracuse, NY. In 1977, he moved to Texas Tech, where he developed and ultimately led the pain program.
Dr. Racz’s academic career was characterized by ceaseless efforts to improve and innovate. A few weeks before his passing, his conversation focused on potential medical innovations and areas for new research. As early as 1976, he pioneered the use of spring-wound, shear-resistant catheter. Initially, this catheter was used to aid in the proper intrathecal placement of phenol for cancer. Coupling this development with an appreciation of the use of hypertonic saline, it was a short step to the creation of the percutaneous adhesiolysis procedure, whose shorthand name is the Racz procedure, done with a Racz catheter.
Dr. Racz’s educational efforts continued on an international scale. He was instrumental in developing the World Institute of Pain, which will be holding the 28th Annual Gabor Racz Pain Conference later this year.
Dr. Racz believed in the three pillars of interventional pain management, efficacy, safety, and patient access. He was always focused on how to change procedural techniques to avoid complications. The blunt needles whose use he pioneered changed the risk profile of arterial impingement.
Gabor Racz’s passion was his belief that no one should live in pain. He believed in his patients and was determined to support and heal them. He was more than a physician; he was their hero.
He said, “Treat your patient as if they were your own mother.”
BREAKING NEWS! Impact of One Big Beautiful Bill on Physician Payment Reform
The budget reconciliation package passed on Thursday, May 22, and included several provisions that would significantly impact physician payments and healthcare overall. Unfortunately, there is no unequivocally good news; rather, we are faced with a mix of potentially good, bad, and ugly developments.
Maybe Good News
Medicare Physician Fee Schedule Updates:
1. Initial Increase: The bill proposes a 2.25% Medicare pay update for physicians in 2026, based on 75% of the Medicare Economic Index (MEI), at a projected cost of $8.9 billion for that year.
Bad News
1. Future payment updates would be tied to the MEI, which tracks inflation and physician practice costs.
However, while linking payment updates to the MEI is a step in the right direction, concerns persist that the proposed MEI updates—capped at 10% annually—will not keep pace with actual inflation and rising practice expenses. This could result in effective increases of less than 0.5%.
2. The physician payment conversion factor is based on three components, including:
• An inflationary index, which is currently projected as 0% for 2025.
• A budget neutrality adjustment would apply solely to physician payments.
• Payments would continue to be influenced by the Merit-Based Incentive Payment System (MIPS). Consequently, CMS retains the authority to convert even minimal positive inflation adjustments into negative adjustments.
3. The continuation of 2% sequestration cuts, initially implemented after the Affordable Care Act, is set to extend through 2032.
4. Broader healthcare provisions will also affect physicians. These include Medicaid cuts, implementation of work requirements, and reductions in multiple assistance programs, which are likely to lead to decreased Medicaid enrollment.
What Is Ugly?
• What is particularly troubling is the ongoing instability of the physician payment system and the continued imposition of 2% sequestration cuts.
• Overall payment reductions could reach as high as 6%, despite the proposed MEI-based increases.
We find ourselves in a critical situation. ASIPP has long been engaged in addressing these challenges through a non-partisan proposal to reform the physician payment system and safeguard telehealth services. The bill is now before the Senate. Please contact your senator individually, through your group, patients, or staff—and urge them to support meaningful reform of the physician payment system. You may also use the convenient link set up by ASIPP: https://www.votervoice.net/ASIPP/Campaigns/127211/Respond
ASIPP Submits Letters to Carelon and Humana Regarding Coverage for Interventional Pain Management Procedures
BREAKING NEWS! ASIPP Submits Non-Partisan Reconciliation Proposal for Physician Payment Reform
Recently, ASIPP submitted to members of Congress, a non-partisan proposal for budget reconciliation for the preservation of Medicare and Medicaid and the reform of the physician payment system.
This proposal is in response to the escalation of health care spending in the United States, which in 2023 was close to $4.9 trillion, a 7.5% increase from the previous year the Congressional Budget Office (CBO), and other sources indicate that net Medicare spending—after accounting for beneficiary premiums—is projected to total $14 trillion over the next decade. Simultaneously, the financial sustainability of physician practices is increasingly under pressure.
Over the past 24 years, physician payment rates have declined by 33%, while practice costs have steadily risen. The cost of medical equipment, supplies, and technology has grown from $30.2 billion in 2017 to $57 billion in 2023, reflecting an average annual growth rate of 6.5%. The overall increase in practice expenses may be even greater, compounding the financial challenges faced by providers. Additionally, a widening gap has emerged: while physician payments have declined, other health care sector payments have continued to rise. Perhaps the most striking is the contrast between insurance premium growth and physician reimbursement rates, with premiums increasing nearly 400% while physician payments have dropped by 33%.
ASIPP’s recommendations build upon previous analyses from MedPAC, CMS, OIG-HHS, and the CBO. The largest projected savings are expected to result from proposed reforms to the Medicare Advantage program exceeding 120 billion per year. Exceeding 120 billion per year, with an estimated savings from specific changes which include:
· Cancellation of the proposed 4.3% payment increase for 2026:
$21 billion per year, or $210 billion over 10 years
· Elimination of payments for veterans already covered by VA insurance:
$15 billion per year, or $150 billion over 10 years
· Ending favorable selection practices: $44 billion per year, or $440 billion over 10 years
· Reforming risk adjustment mechanisms:
$40 billion per year, or $400 billion over 10 years
Collectively, these measures would generate an estimated $120 billion in annual savings from the Medicare Advantage program—totaling $1.2 trillion over a 10-year period.
Click here for the full 48-page Budget Reconciliation proposal. Please consider sending a PAC contribution using the following link: Click HERE to contribute to the ASIPP-PAC.
We cannot emphasize strongly enough how important your contributions are to the work we do toward the preservation of healthcare and especially interventional pain management.
ASIPP Responds to Damaging BMJ Publications Threatening Patient Access to Interventional Spine Care
The American Society of Interventional Pain Physicians (ASIPP) expresses grave concern regarding two recent publications in the British Medical Journal (BMJ) that risk significantly limiting patient care and choice in the management of chronic non-cancer spine pain.
- Letter from ASIPP President, Christopher Gharibo, MD
- Letter from ASIPP Chairman of the Board and CEO Laxmaiah Manchikanti, MD; ASIPP President-Elect Mahendra Sanapati, MD; and Academic Director, Joshua Hirsch, MD
- Formal withdrawal request
To continue this vital conversation, ASIPP will host a dedicated one-hour session at its 2025 Annual Meeting in Orlando. The session will take place on Saturday, May 17, and will be co-chaired by Dr. Christopher Gharibo and Dr. Nick Knezevic. It will include a 30-minute panel discussion with panelists: Alaa Abd-Elsayed, MD; Salahadin Abdi, MD, PhD; Sheri Albers, DO; Alexander Bautista, MD; Miles Day, MD; Shravani Durbhakula, MD; Alan Kaye, MD, PhD; Sean Li, MD; Laxmaiah Manchikanti, MD; Deborah Tracy, MD; Vinita Singh, MD; and Michael Schatman, PhD. ASIPP invites all to attend this important session. Register here.
ASIPP Advocacy Update: ASIPP Recently Met with Congress to Advocate for Several Critical Issues, Including the Extension of Telehealth Services
We want to update you on our recent visit to Washington where several ASIPP members met with key members of Congress, in both the House and Senate.
We advocated for several critical issues, including the extension of telehealth services. While we were unable to secure a permanent extension, we successfully obtained a six-month extension and will continue working for a long-term solution. Additionally, we are making progress on fraud and abuse legislation which will soon be ready for introduction.
We are also working to eliminate the recurring two-percent sequester cut and address abuses in Medicare in Medicare Advantage Plans.
Finally we discussed coverage for Peripheral Nerve Stimulation and emerging CPT coding challenges. We will be sending you a letter soon regarding ASIPP’s advocacy efforts. We encourage you to join us in these important initiatives.
BREAKING NEWS: Bill Passes House for Telehealth Provisions – Senate Must Approve for a 6-Month Extension
Through ASIPP’s extensive advocacy efforts, we were successful in getting language included in the continuing resolution to fund the government through September. This resolution would extend telehealth provisions for another 6 months.
The bill passed in the House on Wednesday while the ASIPP group was still on Capitol Hill. It appears that the extension is working its way through the Senate for approval. We are encouraged, but it has not yet been finalized.
While this is a temporary measure, our focus remains on securing a long-term solution. Many members of Congress and the Senate are advocating for a more permanent extension, ideally lasting 5 to 6 years or longer. ASIPP will continue pushing for this critical advancement.
We will provide further updates on our Capitol Hill visits and ongoing advocacy efforts soon.
BREAKING NEWS! Pain Medicine Case Reports journal has been accepted for inclusion in MEDLINE and PubMed
The American Society of Interventional Pain Physicians is excited to announce that Pain Medicine Case Reports journal (eISSN 2768-5152) has been accepted for inclusion in MEDLINE and PubMed, the prestigious bibliographic database of the U.S. National Library of Medicine. Pain Medicine Case Reports, a companion publication to the prestigious Pain Physician journal by ASIPP, joins its counterpart in achieving indexing in both MEDLINE and PubMed, marking ASIPP’s dual presence in these renowned databases.
The inclusion of Pain Medicine Case Reports journal in MEDLINE signifies a higher level of selectivity, as MEDLINE consists of the top 5,200 biomedical journals. This indexing also means that articles from Pain Medicine Case Reports will be searchable using NLM Medical Subject Headings (MeSH terms) and other metadata.
The selection for MEDLINE follows a rigorous evaluation process by reviewers from the Literature Selection Technical Review Committee (LSTRC). According to their criteria, the scientific quality of a journal’s content is the primary factor considered for indexing.
We extend our congratulations to the Pain Medicine Case Reports Editor-in-Chief, Deputy Editor-in-Chief, Journal Team, and Editorial Board for this achievement, which underscores the significance and excellence of this esteemed journal.
EXTREMELY IMPORTANT NEWS! Telehealth Changes in the Final Rule 2025 of Physician Payments CMS-1807-F and CMS-4201-F5
Thank you for your attention and participation in various activities in protecting medical practices.
We want to bring to your attention critical issues affecting patients across the United States, including those covered by Medicare, Medicare Advantage, Medicaid, and commercial insurers.
The Medicare Final Rule has significantly changed the provision of telehealth services. Starting April 1, 2025, most telehealth services will require patients to be physically present in an office or medical facility located in a rural area. This restriction excludes patients in non-rural areas from accessing telehealth services altogether. Even for those in rural regions, traveling to a designated facility can be extremely difficult, undermining one of telehealth’s primary benefits—providing care from the patient’s home. These changes will impose substantial transportation costs, create burdens for elderly patients who cannot drive, and disrupt the working population that relies on telehealth for accessible care. Currently, approximately 20% of patients depend on telehealth services.
Furthermore, if this rule remains in place, Medicare Advantage, Medicaid, and commercial insurers are expected to adopt similar policies, likely with reduced reimbursements. This will effectively dismantle telehealth services, severely limiting patient access to essential health services.
This issue is crucial for millions of patients across the country, and we hope you will take action to help preserve access to these vital services. We urgently request you to contact CMS and members of Congress (House and Senate).
Please go to VoterVoice and from there, send your letters. You may also copy the letter into your own letterhead or e-mail it directly. We have created a sample letter for your convenience.
Peripheral Nerve Stimulation
Guidelines Available!
The Evidence-Based Clinical Guidelines for the Use of Implantable Peripheral Nerve Stimulation in the Treatment of Chronic Pain from ASIPP are now available! This 92-page publication includes 374 references, 20 tables (plus 8 appendix tables), and 9 figures.
These guidelines support the use of implantable peripheral nerve stimulation leads and neurostimulators in patients with moderate to severe chronic pain refractory to two or more conservative treatments, and aim to optimize patient outcomes and promote health equity through the integration of PNS technology in clinical practice.
Find the full updated guidelines here.
CMS Releases Final 2025 Fee Schedule
CMS has finalized the 2025 Medicare Physician Fee Schedule, implementing a 2.83% cut to Medicare physician reimbursements, as previously outlined.
This cut continues a long trend of decreased reimbursements, originating with the Budget Control Act of 2011 under the Affordable Care Act. As a result, sequester cuts of 2% will remain in effect until 2032 unless Congress enacts a permanent fix to prevent these annual adjustments.
Impact on Interventional Pain Management (IPM) Services:
The final schedule reflects a 2.83% reduction in reimbursements for IPM services.
New Bipartisan Legislation Introduced to Counter Cuts:
Congressman Greg Murphy, M.D., has introduced a bipartisan bill to address this issue. This legislation aims to prevent the proposed reimbursement cut and introduce a payment increase (1.8%) equal to half of the Medicare Economic Index, aligning with recommendations from the Medicare Payment Advisory Commission.
The bill has garnered support from AMA, numerous organizations, including ASIPP. We encourage all members to act by contacting your congressman and senators to support this legislation.
ASC:
There are no major changes for IPM procedures in ASC settings, aside from adjustments in specific codes. Notably, there is a 2% to 3% increase for codes 62361, 62360, 61885, 64590, and 62362, while codes 63688, 64595, 63664, 64585, 63662, 64569, 62350, and 64553 will see a 5% to 7% decrease.
New ICD Codes Effective October 1, 2024
The new ICD-10 codes, effective October 1, 2024, must be implemented immediately to ensure proper reimbursement, including for UDS claims.
The following new codes have been developed:
M51.360: Other intervertebral disc degeneration, lumbar region with discogenic back pain only
Other intervertebral disc degeneration, lumbar region with axial back pain only.
M51.361: Other intervertebral disc degeneration, lumbar region with lower extremity pain only
Other intervertebral disc degeneration, lumbar region with leg pain only.
Other intervertebral disc degeneration, lumbar region with referred sclerotomal pain only.
M51.362: Other intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain
Other intervertebral disc degeneration, lumbar region with discogenic back pain and leg pain.
Other intervertebral disc degeneration, lumbar region with axial back pain and referred sclerotomal pain.
M51.369: Other intervertebral disc degeneration, lumbar region without mention of lumbar back pain or lower extremity pain
Other intervertebral disc degeneration, lumbar region without mention of lumbar back pain or leg pain.
Other intervertebral disc degeneration, lumbar region, NOS.
M51.370: Other intervertebral disc degeneration, lumbosacral region with discogenic back pain only
Other intervertebral disc degeneration, lumbosacral region with axial back pain only.
M51.371: Other intervertebral disc degeneration, lumbosacral region with lower extremity pain only
Other intervertebral disc degeneration, lumbosacral region with leg pain only.
Other intervertebral disc degeneration, lumbosacral region with referred sclerotomal pain only.
M51.372: Other intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain
Other intervertebral disc degeneration, lumbosacral region with discogenic backpain and leg pain
Other intervertebral disc degeneration, lumbosacral region with axial back pain and referred sclerotomal pain
M51.379: Other intervertebral disc degeneration, lumbosacral region without mention of lumbar back pain or lower extremity pain
Other intervertebral disc degeneration, lumbosacral region without mention of lumbar back pain or leg pain
Other intervertebral disc degeneration, lumbosacral region, NOS
M54.5: Low back pain
Excludes1: intervertebral disc degeneration, lumbar region with discogenic back pain only(M51.360)
intervertebral disc degeneration, lumbosacral region with discogenic back pain only(M51.370)
M54.3: Sciatica
Excludes1: intervertebral disc degeneration, lumbar region with lower extremity pain only(M51.361)
intervertebral disc degeneration, lumbosacral region with lower extremity pain only(M51.371)
M54.4 Lumbago with sciatica
Excludes1: intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain (M51.362)
intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain (M51.372)
However, these codes have not been updated with Medicaid, etc. Consequently, for facet joint pain the codes remain M47.816 and M47.817.
Similarly for radicular pain, lumbar radiculitis, M51.16 and M51.17 will remain.
See the following link to CMS: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56818&ver=45&=
Updated Antithrombotic Guidelines Available!
The updated Antithrombotic Guidelines from ASIPP are now available! This 94-page publication includes 412 references, 23 tables, and 15 figures, and offers crucial insights based on extensive research.
Extension of Telehealth Modernization Act of 2024
The Telehealth Modernization Act of 2024, a bipartisan, bicameral legislation, is progressing through Congress, which includes the following:
- Extension of certain telehealth flexibilities removing geographic requirements and expanding origination sites for telehealth services and extending them through the end of December 31, 2026 (was scheduled to expire 12/31/2024).
- This legislation also allows and extends audio only telehealth services, through December 31, 2026 (was scheduled to expire 12/31/2024).
This is great news for patients and providers to maintain access, convenience and to provide cost effective established evaluation and management services. The legislation has been sponsored by bipartisan members of Congress. If you recall, Dr. Larry Bucshon, a member of the Committee on Energy and Commerce and Congressman James Comer, Chairman of the Committee on Oversight and Accountability, discussed this extensively and worked on extending it further. While ASIPP has spearheaded to make this a reality, numerous organizations have worked tirelessly led by AMA.
The only deficiency is that it is not yet permanent. We will continue to work on this issue.
Join the AMA or Renew Your Membership Today!
On behalf of the Board of Directors of the American Society of Interventional Pain Physicians (ASIPP), we ask that you help IPM to maintain a voice in the AMA. Please join the AMA or renew your membership today.
ASIPP previously had two positions in the House of Delegates (HOD), however we just learned that in our 2024 review, we did not have enough ASIPP members on the AMA roster to keep our second seat. Consequently, we now have only one position.
However, it is now time for our 5-year review of our membership AMA match. The member list we send to the AMA every five years is the list they use each year for five years to determine our status. This means that if we fall below the minimum requirement, we stand to lose our only remaining seat.
For ASIPP to retain our seat, the AMA requires that 20% of ASIPP’s physician members also be members of the AMA. ASIPP must submit our member list no later than Monday, April 15. Because of this, we ask that you check your AMA status and renew or join TODAY.
Joining the AMA will strengthen our specialty’s representation at the national level through the AMA HOD the AMA’s policymaking body, and strengthen our ability to meet the challenges in health care today with thoughtful, well-organized responses to issues such as Medicare payment cuts, medical liability reform, etc.
Membership also gives you access to a broad range of practice management resources and award-winning publications, such as the Journal of the American Medical Association, AMNews, AMA Morning Rounds and the Archives journals.
Please support the critical activities of ASIPP by joining the AMA today. To join or renew the AMA, click on the following link: Join or Renew Here.
ASIPP UPDATES
ASIPP is pleased to announce the publication of the Comprehensive Evidence-Based Guidelines for Epidural Interventions in the Management of Chronic Spinal Pain. In preparation of the guidelines, an extensive literature review was performed. The 210-page guidelines contains 33 figures, 48 tables, 1,345 references and has 60 authors.
In addition to the review of multiple manuscripts in reference to utilization, expenditures, anatomical and pathophysiological considerations, pharmacological and harmful effects of drugs and procedures, for evidence synthesis, we have included 47 systematic reviews and 43 RCTs covering all epidural.
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ANNOUNCEMENTS
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Doctor Finder allows you to search for an ASIPP® Member Interventional Pain Physician anywhere in America by name or by location. It’s quick and easy.
Since this malpractice insurance program officially launched in November 2018, ASIPP has signed up hundreds of providers with an average savings of 30%. This is professional liability insurance tailored to our specialty and will stand up for us and defend our practices.
Curi is a full-service advisory firm that serves physicians and their practices. Their valued advice is grounded in your priorities and elevated in your outcomes. They are driven by a deep understanding of your specific circumstances in medicine, business, and life. To read a few important points to keep in mind about the program, including discounts, administrative defense, cyber coverage, aggressive claims handling, and complimentary risk management CME activities, click here.
PainExam is proud to announce that it now offers preparation for the ABIPP Pain Management Board Exam! In addition, PainExam has now collaborated with ASIPP to offer Virtual Learning programs.
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PainCast, the pain management network, has collected years worth of information on the history and processes of the pain management specialization and transformed it into a virtual library of videos, journals, articles, podcasts, and more – all at your fingertips.
Leading experts in their respective fields contributed chapters on specific topics to present a cogent and integrative understanding of the field of regenerative medicine as applicable for interventional pain physicians.
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This comprehensive review covers the full and latest array of interventional techniques for managing chronic pain and features new chapters covering challenges with opioid therapy, impact of COVID-19, and spinal interventional techniques.
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ASIPP has formed a partnership with Henry Schein and PedsPal, a national GPO that has a successful history of negotiating better prices on medical supplies and creating value added services for the independent physician.
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ASIPP is now offering our members the benefit of a unique revenue cycle management/billing service. We have received a tremendous amount of interest in the ASIPP billing and coding program.
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