November 07, 2025
What You Need to Know: CMA has signed on to a national multispecialty coalition letter urging Noridian Healthcare Solutions to withdraw or substantially revise a proposed Medicare policy that would eliminate coverage for many peripheral nerve block and radiofrequency ablation procedures used to treat chronic pain. In a separate comment letter, CMA emphasized its opposition to creating new procedure registries, warning that additional reporting mandates would burden practices and divert time from patient care.
The California Medical Association (CMA) has signed on to the Multisociety Pain Workgroup letter opposing Noridian Healthcare Solutions’ proposed local coverage determination (LCD DL40265), Peripheral Nerve Blocks and Procedures for Chronic Pain. The proposed LCD would deny Medicare coverage for a wide range of peripheral nerve block, peripheral nerve radiofrequency ablation, and related interventional procedures used to treat chronic pain.
In addition to joining the coalition letter, CMA submitted its own statement underscoring strong evidence supporting these procedures and urging Noridian to avoid adding new data-registry requirements that could increase costs and administrative complexity for physician practices.
Chronic pain and the importance of non-opioid options
Chronic pain is a leading cause of disability among Medicare beneficiaries. National data show that more than 50 million adults live with chronic pain, including 17 million experiencing “high-impact” pain that limits daily activities. Chronic pain is linked to depression, dementia, suicide risk, and increased substance use, as well as substantial health care costs.
Federal agencies such as the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services (HHS) have called for expanded access to non-opioid and interventional pain-management options. CMA and other medical societies warn that Noridian’s proposal runs counter to these directives by restricting procedures that help patients manage pain safely and reduce opioid use.
Consequences of eliminating coverage
CMA and the coalition cautioned that eliminating coverage for peripheral nerve procedures could have significant unintended consequences for Medicare beneficiaries, including:
- Increased reliance on opioids and other systemic medications
- Greater use of invasive surgeries, including joint replacements and revisions
- More emergency-department visits and hospitalizations for uncontrolled pain
- Loss of mobility, independence, and quality of life for older adults
Current Medicare spending on these procedures is modest compared with the costs of surgery and long-term medication use. Even small increases in surgical volume or opioid-related complications could outweigh any projected savings.
A call for evidence-based collaboration
CMA and its coalition partners urged Noridian to withdraw or substantially revise the proposed LCD and work with physician experts to develop evidence-based coverage criteria aligned with current science and federal opioid-reduction goals. CMA further cautioned against requiring new procedure registries, instead encouraging use of existing quality-reporting mechanisms to limit administrative burden.
CMA will continue to engage with Noridian, CMS and physician stakeholders to ensure Medicare coverage decisions support evidence-based, non-opioid pain care and protect patient access to effective treatments.
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