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Multisociety Effort Results in UHC Coverage Change for Pain Procedure

Members & Publications

January 18, 2022

UnitedHealthcare (UHC) has revised its coverage decision regarding dorsal root ganglion stimulation (DRG-S) following a joint letter submitted in December by AAPM&R and several other pain-related specialties in the Multisociety Pain Workgroup. UHC's updated policy is effective March 1, 2022. This revised policy notes that DRG-S "is proven and medically necessary for treating complex regional pain syndrome (CRPS 1, CRPS 2) when used according to FDA guidelines." AAPM&R continues to work with the Multisociety Pain Workgroup, which functions to unify the voice of several pain management specialties to address coverage issues.

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.

 

 

 

 

 

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