Medicare has released a proposed Local Coverage Determination (LCD) that would eliminate coverage for nearly all peripheral nerve block and related procedures for chronic pain. The proposed LCDs were released by Medicare Administrative Contractors (MACs) — CGS, NGS, Noridian, Palmetto, and WPS, MACs overseeing 24 states across the country.

This proposal represents a significant rollback of access to evidence-based pain management therapies and threatens patients’ ability to receive treatments that help restore mobility, reduce opioid reliance, and improve quality of life. The proposed LCDs provide coverage only for radio frequency neurolysis for trigeminal neuralgia, corticosteroid injections for median neuropathy at the wrist (limited to a maximum of three injections), and corticosteroid injections for Morton’s neuroma (limited to a maximum of two injections).

How to Submit Comments on the Medicare Peripheral Nerve Block Draft LCD

AOCPMR encourages members to submit public comments directly to their respective MACs by Saturday, Nov. 8, for CGS, NGS, Noridian, and Palmetto, and Saturday, Nov. 22 for WPS.

Comments may be submitted directly through each Medicare Administrative Contractor (MAC) by using these links:

NGS (DL40267): Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey

Noridian (DL40265): Alaska, Arizona, California, Hawaii, Nevada, Oregon, Washington

Palmetto (DL40263): Virginia, North Carolina, South Carolina, West Virginia

CGS (DL40261): Kentucky, Ohio

WPS (DL40300): Michigan, Wisconsin, Illinois