The American Medical Association (AMA) is collecting physician feedback on the implementation of the Centers for Medicare & Medicaid Services' (CMS) Wasteful and Inappropriate Service Reduction (WISeR) Model in your state.

In the first six months of implementation, physicians have reported to the AMA:

• Processing delays
  
• Increased denial rates
  
• Inconsistencies between WISeR criteria and Medicare coverage policies

For interventional pain physicians, WISeR review requirements may affect services such as epidural steroid injections and other procedures commonly performed in practice.

By sharing your feedback, you can help IPSIS and the AMA document the real-world impact of AI-supported review programs and hold the line against inappropriate denials, delays, and barriers to medically necessary care before similar models are adopted more broadly across the country.

Click here to begin the survey.

🔒 IPSIS members practicing in WISeR states also have access to members-only implementation guidance designed to help interventional pain physicians navigate the model's prior authorization and pre-payment review requirements.

IPSIS advances policies that expand access to safe, effective care for patients with debilitating pain. Through clinical guidance, federal policy leadership, and coordination with collaborating societies, IPSIS is at the forefront of protecting patient access. Support this advocacy with your donation.

The International Pain and Spine Intervention Society (IPSIS) is a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. Contributions are deductible to the extent allowed by law.

IPSIS Health Policy Division Chair W. David Mauck, MD, and IPSIS Advocacy Committee Chair Kate Sayeed, MD, are representing IPSIS at the American Medical Association (AMA) Annual Meeting of the House of Delegates (HOD) in Chicago, Illinois. Click here to access the reports and resolutions under consideration.

The AMA HOD establishes policy on health, medical, and professional matters, so it is crucial that interventional pain medicine interests are represented. Our participation in the HOD also allows IPSIS to hold advisory seats with the CPT Editorial Panel and the RVS Update Committee (RUC) to ensure our voice is heard regarding important coding and reimbursement issues.

IPSIS holds a seat at this and other AMA forums by demonstrating strong AMA membership among our members. IPSIS urges all members to maintain their AMA membership to help ensure that interventional pain specialists continue to be heard.

The International Pain and Spine Intervention Society’s Dr. Wesley R. Ibazebo MD, and Graham E. Wagner MD, represented IPSIS members at the April 2026, American Medical Association (AMA) Relative Value Update Committee (RUC) meeting in Chicago, Illinois.

RUC is an advisory body to the Centers for Medicare and Medicaid Services (CMS) that reviews medical procedures and provides Relative Value Unit (RVU) recommendations. The recommendations approved at this meeting will be presented for final authorization and publication in the next Medicare Physician Fee Schedule.

IPSIS holds a seat at this and other AMA forums by proving that a high percentage of our members also maintain membership in the AMA. IPSIS urges all members to maintain their AMA membership to assure that the voice of interventional pain specialists continues to be heard.

Disputes must be initiated by May 15, 2026, to be reflected in the June 1, 2026, data publication. 

The CMS website displays records of “transfers of value” from industry, including items over $11 or more than $100 annually in smaller gifts. These data cover any compensation reported by drug, device, biological, and medical supply manufacturers to physicians and teaching hospitals.

Learn more on CMS’ Open Payments Resource page.

IPSIS supports members by promoting accurate federal reporting, helping protect professional reputations and ensuring interventional pain medicine is accurately represented in reported data. Support this advocacy with your donation.

The International Pain and Spine Intervention Society (IPSIS) is a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. Contributions are deductible to the extent allowed by law.

• PATIENT SAFETY: Ultrasound guidance is important in higher-risk anatomic regions near nerves, vessels, lungs, or other structures.

• PROCEDURAL ACCURACY: It may improve accuracy, especially in deeper or more complex muscle groups.

IPSIS rallied the Multisociety Pain Workgroup (MPW) to coordinate and submit comment letters to First Coast Service Options and Novitas, leveraging the collective influence of participating specialty societies.

IPSIS advances policies that expand access to safe, effective care for patients with debilitating pain. Through its leadership in federal policy and clinical guidance, IPSIS protects patient access. Support this advocacy with your donation.

The International Pain and Spine Intervention Society (IPSIS) is a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. Contributions are deductible to the extent allowed by law.

Key concerns:

• Reduced patient access: Coverage limits would create barriers for Medicare beneficiaries with chronic pain.
• Evidence-based care at risk: PNBs are a long-established, essential part of pain management.
• Unintended consequences: Restrictions may push patients toward less appropriate or higher-risk treatments, including opioids.
  

IPSIS and the PMC urge CMS and Medicare Administrative Contractors (MACs) to withdraw these proposals and protect access to essential non-opioid pain care.

IPSIS advances policies that expand access to safe, effective care for patients with debilitating pain. Through its leadership in federal policy and clinical guidance, IPSIS protects patient access. Support this advocacy with your donation.

The International Pain and Spine Intervention Society (IPSIS) is a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. Contributions are deductible to the extent allowed by law.

• Robust clinical data
• FDA clearance
• Medicare national and local coverage policies
  

We remain committed to ensuring appropriate patient access to PNS procedures. IPSIS-led advocacy has also addressed PNS coverage with BCBS plans in Illinois, Montana, New Mexico, Oklahoma, and Texas.

IPSIS is on the forefront of the fight for interventional pain procedures — advocating for evidence-based policies that expand access to safe, effective treatment for people suffering from debilitating pain. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

• clarifying psychological screening requirements,
• allowing flexibility in imaging when MRI is not feasible, emphasizing clinical context alongside imaging findings, and
• refining osteoporosis and exclusion criteria to reflect current evidence.

IPSIS is on the forefront of the fight for interventional pain procedures — advocating for evidence-based policies that expand access to safe, effective treatment for people suffering from debilitating pain. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

IPSIS is on the forefront of the fight for interventional pain procedures — advocating for evidence-based policies that expand access to safe, effective treatment for people suffering from debilitating pain. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

IPSIS is represented by Dr. Yusef Sayeed at the February 2026 American Medical Association (AMA) Current Procedural Terminology (CPT®) Editorial Panel meeting in Palm Springs, California.

As you know, the CPT® code set is used to bill outpatient and office procedures. But did you know that IPSIS members can take advantage of IPSIS's coding expertise to clear up any confusion that they may have coding their practices' procedures? Submit your billing and coding questions here🔒.

IPSIS holds a seat at this and other AMA forums by proving that a high percentage of our members also maintain membership in the AMA. IPSIS urges all members to ensure that their AMA membership is current to ensure that the voice of interventional pain specialists continues to be heard.

Graham E. Wagner MD and W. David Mauck, MD, are representing IPSIS members at the January 2026, American Medical Association (AMA) Relative Value Update Committee (RUC) meeting in Beverly Hills, California.

RUC is an advisory body to the Centers for Medicare and Medicaid Services (CMS) that reviews medical procedures and provides Relative Value Unit (RVU) recommendations. The recommendations approved at this meeting will be presented for final authorization and publication in the next Medicare Physician Fee Schedule.

IPSIS holds a seat at this and other AMA forums by proving that a high percentage of our members also maintain membership in the AMA. IPSIS urges all members to ensure that their AMA membership is current to ensure that the voice of interventional pain specialists continues to be heard.

IPSIS, advocates for evidence-based policies that expand access to safe, effective treatments for individuals suffering from debilitating pain and stands against "black box" prior authorization models — seeking a unified, standards-based prior authorization system as mandated by CMS. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

• Epidural steroid injections for pain management
• Percutaneous vertebral augmentation for vertebral compression fractures
• Percutaneous image-guided lumbar decompression for lumbar spinal stenosis
• Neurolytic destruction of the trigeminal nerve

Joining IPSIS and maintaining membership ensures you have timely access to detailed summaries and practice-relevant resources, not just high-level headlines, and helps you stay up-to-date with the latest information that matters to your practice and patients. Staying informed is essential as WISeR begins to influence clinical workflows, documentation expectations, and reimbursement processes in the pilot states.

If it's time to renew your membership, now is the moment to ensure uninterrupted access to these critical updates and member resources. Click here to contact us for assistance.

IPSIS, advocates for evidence-based policies that expand access to safe, effective treatments for individuals suffering from debilitating pain and stands against "black box" prior authorization models — seeking a unified, standards-based prior authorization system as mandated by CMS. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

• epidural steroid injections for pain management,
• percutaneous vertebral augmentation for vertebral compression fracture,
• percutaneous image-guided lumbar decompression for lumbar spinal stenosis, and
• neurolytic destruction of the trigeminal nerve.

On December 4, 2025, CMS will host a Q&A session to walk providers through how the model will work and answer questions. Click here to register.
 

IPSIS, advocates for evidence-based policies that expand access to safe, effective treatments for individuals suffering from debilitating pain and stands against "black box" prior authorization models — seeking a unified, standards-based prior authorization system as mandated by CMS. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

Drs. W. David Mauck and Kate Sayeed are representing IPSIS at the American Medical Association (AMA) Interim Meeting of the House of Delegates (HOD) in National Harbor, Maryland. Click here to access the reports and resolutions under consideration.

The AMA HOD establishes policy on health, medical, and professional matters, so it is crucial that interventional pain medicine interests are represented. Our participation in the HOD also allows IPSIS to hold advisory seats with the CPT Editorial Panel and the RVS Update Committee (RUC) to ensure our voice is heard regarding important coding and reimbursement issues.

IPSIS holds a seat at this and other AMA forums by proving that a high percentage of our members also maintain membership in the AMA. IPSIS urges all members to ensure that their AMA membership is current to ensure that the voice of interventional pain specialists continues to be heard.

This bipartisan bill would lift current restrictions on physician-owned hospitals (POHs). The change would allow physicians to open and expand hospitals that deliver high-quality, cost-effective care while increasing competition and patient choice.

In a joint letter to Congress, our societies emphasized that POHs consistently achieve strong outcomes and patient satisfaction, countering claims that they “cherry-pick” patients. The letter urges swift passage of H.R. 4002 to promote innovation, quality, and access across the health care system
 

IPSIS advocates for evidence-based policies that expand access to safe, effective treatments for individuals suffering from debilitating pain. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

• PNBs and RFA are integral to precision-based pain management and have decades of demonstrated clinical use across multiple specialties, including Pain Medicine, PM&R, Anesthesiology, Neurology, and Radiology.
• The proposed LCDs disregard multisociety guidelines and peer-reviewed literature confirming the effectiveness of these therapies for conditions such as occipital neuralgia, complex regional pain syndrome (CRPS), and knee osteoarthritis.
• Removing coverage for these procedures would contradict CMS’s own opioid reduction and value-based care initiatives, likely leading to increased reliance on opioid medications, costly surgeries, and diminished quality of life for Medicare beneficiaries living with chronic pain.

Our societies stand ready to engage directly with the MAC medical directors to ensure that any future LCDs accurately reflect the best available evidence and preserve access to effective, non-opioid pain management options.

IPSIS advocates for evidence-based policies that expand access to safe, effective treatments for individuals suffering from debilitating pain. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

IPSIS advocates for evidence-based policies that expand access to safe, effective treatments for individuals suffering from debilitating pain. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

If enacted, this proposal would abruptly eliminate coverage of:

• Occipital nerve blocks for migraine and headache disorders
• Stellate ganglion blocks for Complex Regional Pain Syndrome (CRPS) and facial pain
• Trigeminal, pudendal, ilioinguinal, and iliohypogastric nerve blocks for neuralgias and pelvic pain
• Cluneal and suprascapular nerve radiofrequency ablation (RFA) for axial and shoulder pain
• Genicular nerve RFA for knee osteoarthritis and post-surgical knee pain

TAKE ACTION NOW TO PRESERVE COVERAGE

1. Sign the Change.org Petition. It only takes a minute to show your support.
2. Submit Your Comments Directly to the MACs.

• CGS (DL40261) Open Comment Period: closes 11/8
• NGS (DL40267) Open Comment Period: closes 11/8
• Noridian (DL40265) Open Comment Period: closes 11/8
• Palmetto (DL40263) Open Comment Period: closes 11/8
• WPS (DL40300) Open Comment Period: closes 11/22

RESOURCES
Get the facts and help your patients understand what’s at stake:

• Physician Flyer
• Patient Flyer

DEADLINE: NOVEMBER 8, 2025

ACT NOW! Your voice helps protect the integrity of clinical decision-making and access to evidence-based, effective patient care.

IPSIS advocates for evidence-based policies that expand access to safe, effective treatments for individuals suffering from debilitating pain. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

• shifting coverage information away from physicians to back offices, and
• creating opaque, payer-specific coverage companion guides.

This industry push-back seeks to undermine reforms critical to increasing transparency about the wide range of coverage variations between American health plans.

IPSIS advocates for evidence-based policies that expand access to safe, effective treatments for individuals suffering from debilitating pain. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

• the robust PNS clinical data,
• FDA clearance, and
• Medicare national and local coverage policies demonstrating that PNS is an evidence-based therapy for neuropathic pain.

The plans involved include: BCBS of Illinois, Montana, New Mexico, Oklahoma, and Texas. Their stance fails to reflect the substantial clinical evidence supporting PNS effectiveness. IPSIS is determined to ensure that patients can continue to have appropriate access to these valuable procedures.

IPSIS advocates for evidence-based policies that expand access to safe, effective treatments for individuals suffering from debilitating pain. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

A proposed Local Coverage Determination (LCD) wrongly classifies peripheral nerve blocks and radiofrequency ablation (RFA) as not medically necessary. We urge all pain medicine stakeholders to submit comments to their Medicare Administrative Contractors (MACs) and to register for and participate in open meetings to prevent this policy from going into effect (dates and links below).

Your voice matters. Physician input is critical to ensure Medicare coverage decisions reflect clinical evidence and patient need. Strong engagement from the pain community is essential to protect access to effective interventional treatments.

View Proposed LCD and Submit Comments by November 8, 2025

• CGS
• NGS
• Noridian
• Palmetto
• WPS

Open Meetings Info (Central Time):

• CGS: Tuesday, 10/28, 3–4:30 PM
• NGS: Thursday, 10/30, 11 AM–1 PM
• Noridian: Thursday, 10/30, 2–4 PM
• Palmetto: Monday, 10/27, 9–11 AM or 12–2 PM
• WPS: Wednesday, 10/22, 1–3 PM
  

IPSIS will also represent members at several of the open meetings. We are preparing a comprehensive comment letter and will seek Multisociety Pain Work Group endorsement and sign-on prior to submission.

IPSIS advocates for evidence-based policies that expand access to safe, effective treatments for individuals suffering from debilitating pain. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

IPSIS advocates for evidence-based policies that expand access to safe, effective treatments for individuals suffering from debilitating pain. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.

IPSIS holds a seat at this and other AMA forums by proving that a high percentage of our members also maintain membership in the AMA. IPSIS urges all members to ensure that their AMA membership is current to ensure that the voice of interventional pain specialists continues to be heard.

As you know, the CPT® code set is used to bill outpatient and office procedures. But did you know that IPSIS members can take advantage of IPSIS's coding expertise to clear up any confusion that they may have coding their practices' procedures? Submit your billing and coding questions here 🔒.

IPSIS holds a seat at this and other AMA forums by proving that a high percentage of our members also maintain membership in the AMA. IPSIS urges all members to ensure that their AMA membership is current to ensure that the voice of interventional pain specialists continues to be heard.