In draft local coverage determinations published in October 2025, five Medicare Administrative Contractors proposed classifying therapeutic peripheral nerve blocks, peripheral nerve denervation, and radiofrequency ablation as “not reasonable and necessary” for chronic pain. Commercial insurers are already following suit: Blue Cross NC adopted a genicular nerve block policy in March 2026 that cites the proposal directly. The Pain Medicine Coalition met with MAC representatives in January 2026, and the question remains unresolved.

Read it: Where the nerve block coverage fight stands now (Becker’s ASC)

WHY IT MATTERS If finalized, these policies could reshape what we can offer patients with chronic pain. How should our specialty organize its advocacy response?