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.

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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/

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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/

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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/