In order to assist members in meeting the requirements outlined by Medicare Administrative Contractors (MACs), IPSIS has provided the relevant local coverage determinations related to interventional pain and spine procedures for each U.S. state as well as certain territories. More information can be found on the CMS website. To find your local MAC, click here. 

Medicare Administrative Contractors

Cigna Government Services (CGS)

• Epidural Steroid Injections for Pain Management
• Facet Joint Interventions for Pain Management
• Sacroiliac Joint Injections and Procedures

First Coast Service Options (FCSO)

• Epidural Steroid Injections for Pain Management
• Facet Joint Interventions for Pain Management

National Government Services (NGS)

• Epidural Steroid Injections for Pain Management
• Facet Joint Interventions for Pain Management
• Sacroiliac Joint Injections and Procedures
  

Noridian

• Epidural Steroid Injections for Pain Management (Jurisdiction E)
• Epidural Steroid Injections for Pain Management (Jurisdiction F)
• Facet Joint Interventions for Pain Management (Jurisdiction E)
• Facet Joint Interventions for Pain Management (Jurisdiction F)
• Sacroiliac Joint Injections and Procedures (Jurisdiction E)
• Sacroiliac Joint Injections and Procedures (Jurisdiction F)

Novitas

• Epidural Steroid Injections for Pain Management
• Facet Joint Interventions for Pain Management 

Palmetto

• Epidural Steroid Injections for Pain Management
• Facet Joint Interventions for Pain Management
• Sacroiliac Joint Injections and Procedures

WPS Government Health Administrators

• Epidural Steroid Injections for Pain Management
• Facet Joint Interventions for Pain Management
• Sacroiliac Joint Injections and Procedures

Why Is My State Not Listed?

If your state's policy is not listed, you should clearly document medical necessity. You may also want to explore policies from other states for reference. Please note that each policy comes with an effective date and it is crucial to keep this in mind as policies are subject to regular updates.

IPSIS does not assume responsibility for the content or precision of these policies but maintains and offers this compilation as a service to its members. For questions about a policy, contact your carrier directly or email advocacy@spineintervention.org