Advocacy Update: Advancing Patient Access to Evidence-Based Pain Care
April 6, 2026: AAPM continues to actively advocate for our members to have access to the full range of evidence-based tools needed to deliver the right therapy to the right patient at the right time. Through direct engagement with payers and policymakers, we are working to remove barriers that limit appropriate, patient-centered pain care.
AAPM has urged major insurers, including Cigna, Elevance Health, and UnitedHealthcare, to update their policies that currently classify peripheral nerve stimulation (PNS) as investigational or not medically necessary. As outlined in our letters, PNS is supported by a robust and growing body of evidence, including randomized controlled trials, FDA-cleared technologies, and national clinical guidelines. It represents a minimally invasive, non-opioid treatment option that improves pain, function, and quality of life for appropriately selected patients with chronic pain.
In parallel, AAPM joined the Multisociety Pain Workgroup (MPW) to comment on Medicare coverage policies impacting interventional pain procedures. These efforts include advocating for coverage of ultrasound guidance in trigger point injections to improve procedural accuracy and patient safety, particularly in anatomically sensitive regions.
AAPM and partner societies have also provided detailed recommendations to refine proposed Medicare coverage criteria for basivertebral nerve ablation (BVNA), emphasizing the need to avoid unnecessary administrative barriers while maintaining appropriate patient selection.
Across all efforts, AAPM’s advocacy is grounded in a consistent principle: policies should reflect current evidence, support multidisciplinary, patient-centered care, and ensure access to the full spectrum of effective pain management options. We remain committed to working collaboratively with payers and policymakers to advance coverage policies that improve patient outcomes and reduce reliance on more invasive or higher-risk treatments.
If you are an AAPM member and passionate about ensuring your patients have access to evidence-based therapies, consider joining the Pain Medicine Policy Committee by emailing us at info@painmed.org.
Proposed LCD on Peripheral Nerve Blocks and Procedures for Chronic Pain
Medicare released a Proposed LCD on Peripheral Nerve Blocks and Procedures for Chronic Pain, with the elimination of all peripheral nerve blocks from coverage policy. The deadline for providing public comments is November 8, 2025. The American Academy of Pain Medicine has been working hard on your behalf to protect patient access to these procedures. Academy leaders attended the open meetings and coordinated our oral comments with multiple pain societies to ensure that the points made by society representatives were not redundant. We focused on sharing the LCD’s impact on patients.
AAPM submitted its open comments to the five Medicare Administrative Contractors (MACs) on November 7th, and we signed on to the Multisociety Pain Workgroup (MPW) Letters. The Academy addressed each procedure in its response. We recommend reading our initial alert, Medicare Releases Proposed LCD on Peripheral Nerve Blocks and Procedures for Chronic Pain, With Elimination of All Peripheral Nerve Blocks from Coverage Policy, posted on October 14th, for additional background on the proposed LCD. Another great read on the topic is a recent Voices in Pain Medicine blog post, “Preserving Access to Peripheral Nerve Blocks for Chronic Pain: Two Resident Physicians’ Perspectives on Medicare’s Proposed Local Coverage Determination (LCD),“ written by Eric Toan Phong Nguyen, DO, and David Jevotovsky, MD, MBA.
We also encourage you and your patients to sign the ‘Restore Medicare Access to Procedures – End Discrimination and Geographic Inequality’ petition on Change.org.
Click on the links below to review AAPM’s open comments to each of the five impacted MACs.
AAPM to CGS – Peripheral Nerve Block LCD
AAPM to NGS- Peripheral Nerve Block LCD
AAPM to Noridian- Peripheral Nerve Block LCD
AAPM to Palmetto – Peripheral Nerve Block LCD
AAPM to WPS – Peripheral Nerve Block LCD
MultiSociety Pain Workgroup Letter (This letter was sent to all five MACs)
The American Academy of Pain Medicine would like to recognize and thank the numerous volunteers who spent significant time and effort on drafting our public comments.
James Babington, MD
Antje Barreveld, MD
Alexandra Adler, MD
Fei Cao, MD
Zheyan Chen, MD
Jianguo Chen, MD
Philip Kim, MD
Timothy Furnish, MD
Jennifer Myunghae Hah, MD
Tigran Kesayan, MD
Narayan Kissoon, MD
Zachary McCormick, MD
Kate Nicholson, JD
Michael D. Osborne, MD
Nilesh Patel, MD, MBA
Jeffrey D. Petersohn, MD
David Provenzano, MD
Joshua Rosenow, MD, FAANS, FCNS, FACS
Nathaniel Schuster, MD
Wahenoor Singh, DO
Priyanka Singla, MD
Affecting health care on behalf of our specialty
AAPM supports pain patients and pain medicine clinicians by advocating for a balanced approach to safe and effective pain treatment. AAPM works to influence legislators, payors, and others in a position to set policies that impact patients.
The Academy recognizes the need for policies that support effective control of drug abuse without harming the appropriate treatment of pain and works with members and other pain societies to establish programs and to educate the public along those lines.
AAPM members are sought-after opinion leaders who serve on many key national coalitions and federal agency workgroups.
AMA House of Delegates Representation
AAPM holds a seat in the American Medical Association House of Delegates (HOD) and speaks for its members concerning issues critical to their pain practices. The HOD is the principal policy-making body of the American Medical Association.
This democratic forum represents the views and interests of a diverse group of member physicians from all 50 state medical associations and more than 120 medical specialty societies. Delegates meet twice per year to establish policies on health, medical, professional and governance matters, as well as the principles within which the AMA’s business activities are conducted.
Representation in the HOD is apportioned to medical specialty societies based on the portion of its physician members who also maintains AMA membership.
Because you and your peers have joined AMA, your voice is being heard. If you are not one currently, we encourage you to become an AMA member.
Meet Your AAPM Representatives
Michael Lubrano, MD, MPH represents the American Academy of Pain Medicine at the American Medical Association. He has built important relationships through serving on the AMA HOD Resident & Fellow Section Governing Council, AMA Council on Science and Public Health, AMA RVS Update Committee, the AAPM Alternate HOD Delegate, and now AAPM HOD Delegate.
“As AAPM Delegate to the AMA I represent the healthcare policy interests of the AAPM to the AMA House of Delegates. I am responsible for advocating for the healthcare needs of our acute and chronic pain patients across the country as well as any policies that support the clinician members of our diverse, multi-specialty organization in their efforts to provide high quality medical care to pain patients across the United States.”
Where Else Does AAPM Advocate?
Multisociety Pain Workgroup
AAPM participates in the Multisociety Pain Workgroup, a coalition of Medical Specialty Societies that collectively advocates for continued coverage of important pain treatment options.
Collectively, MPW Societies represent 100,000+ members dedicated in whole or in part to Pain Medicine.
National Pain Strategy
AAPM supports the National Pain Strategy (NPS), developed by the US Department of Health and Human Services, which many AAPM leaders helped to shape.
AAPM believes that successful implementation of the strategic goals in the NPS will create the cultural transformation of pain prevention, care, and education desperately needed for the American public.