CMS proposed restrictions on peripheral nerve blocks and procedures for chronic pain: clinical, ethical, and policy implications for millions of Americans
Year: 2026
Type: article
Abstract: Chronic pain affects nearly 1 in 4 adults in the United States and imposes profound burdens on individuals, and the healthcare system. Peripheral nerve blocks (PNBs) and related interventional procedures are essential components of modern multimodal pain management. They offer targeted, reversible, and cost-effective diagnostic, prognostic and therapeutic benefits for a broad array of conditions. The recently proposed “Local Coverage Determination (LCD) for Peripheral Nerve Blocks and Procedures for Chronic Pain” threatens to severely limit access to these evidence-based interventions. As a multidisciplinary group of clinicians, researchers, and a patient advocate writing on behalf of the American Academy of Pain Medicine (AAPM), we urge the Centers for Medicare and Medicaid Services (CMS) to rescind the proposed LCD and collaborate with subject matter experts to develop clinically and scientifically sound, patient-centered coverage criteria. Federal guidelines emphasize multimodal, interdisciplinary care. The Health and Human Services (HHS) Pain Management Best Practices Inter-Agency Task Force Report (pmtf-final-report-2019-05-23.pdf) and Centers for Disease Control and Prevention (CDC) 2022 Clinical Practice Guideline for Prescribing Opioids for Pain (CDC Clinical Practice Guideline for Prescribing Opioids for Pain–United States, 2022 | MMWR) recommend integrating behavioral, physical, pharmacologic, and interventional approaches to reduce reliance on opioids and improve outcomes. By limiting coverage for widely used interventional procedures, the proposed LCD conflicts with federal guidance and risks reversing important progress in improving patient safety and decreasing opioid-related morbidity and mortality in the United States.
Source: Pain Medicine
DOI: 10.1093/pm/pnag031
Authors: Priyanka Singla, James R Babington, Alexandra Adler, Fei Cao, Zheyan Chen, Jianguo Cheng, Timothy Furnish, Jennifer M Hah, Marie N Hanna, Tigran Kesayan, Philip Kim, Narayan R Kissoon, Zachary L McCormick, Kate Nicholson, Michael D Osborne, Nilesh Patel, Jeffrey D Petersohn, David A Provenzano, Joshua M Rosenow, Nathaniel M Schuster, Wahenoor Singh, Amol Soin, Antje M Barreveld
Institutions: University of Virginia, Swedish Medical Center, Tufts University, Lowell General Hospital, Truman Medical Center, University of Missouri–Kansas City, Oregon Health & Science University, Cleveland Clinic, UC San Diego Health System, Stanford Medicine, Stanford University, Johns Hopkins University, Mayo Clinic, University of Utah, Mayo Clinic in Florida, State College of Florida Manatee-Sarasota, Sewickley Valley Hospital, Northwestern University, Morehouse School of Medicine, Wright State University, Newton Wellesley Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7130928581