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AAPM&R Supports MPW Letter to Humana Regarding Coverage of Peripheral Nerve Stimulation

Members & Publications

April 3, 2024

Humana’s Medicare Advantage policy, effective January 1, 2024, does not cover peripheral nerve stimulators (PNS) for treating chronic pain. This is inconsistent with Medicare Fee-For-Service, Medicare Parts A and B, National Coverage Determinations, and Local Coverage Determinations, which all cover these PNS for certain patients. PNS has proven to be an effective treatment for many chronic pain conditions in hundreds of clinical studies, and in data showing PNS services were utilized by Medicare patients over 46,000 times between 2018-2022. This month, AAPM&R joined the Multi-specialty Pain Workgroup in urging Humana to revise its policy to align with Medicare’s coverage and ensure equitable access for its beneficiaries. If you have any comments or concerns, please contact healthpolicy@aapmr.org.

    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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