Medicare-Covered Interventional Procedures for Chronic Pain

Living with chronic pain can mean more than physical discomfort—it can affect every part of life, from sleep and mobility to independence and emotional health. For Medicare beneficiaries, relief doesn’t have to come solely from prescription pain medications or long-term opioid therapy. Medicare Part B covers a range of interventional procedures that offer targeted, often lasting relief when conservative treatments haven’t worked.

Over 50 million Americans suffer from chronic pain. For those who qualify, Medicare can help cover the costs of treatments like spinal injections, nerve blocks, and even spinal cord stimulators. These procedures are usually reserved for patients who have documented failure with treatments like physical therapy, occupational therapy, chiropractic services, or acupuncture for chronic low back pain.

Coverage under Medicare Part B generally pays for 80% of approved costs after the annual deductible ($257 in 2025), though prior authorization is often required. In this guide, we’ll walk through the most commonly covered procedures, eligibility requirements, documentation expectations, and how a Solace advocate can help you get the care you need—without unnecessary delays or denials.

Understanding what Medicare considers "medically necessary" is key. Without the right paperwork and process, even effective, evidence-based pain procedures can be denied. Here’s what to know.

Understanding Medicare Coverage for Interventional Pain Procedures

Before diving into the specifics of what’s covered, it helps to understand how Medicare evaluates interventional pain management. These procedures fall under Medicare Part B and are subject to strict documentation and provider requirements.

What Qualifies as "Interventional Pain Management"

Interventional pain management refers to targeted procedures that directly address the physical source of chronic pain—unlike systemic treatments such as prescription pain medications. Medicare classifies many of these procedures as outpatient services under Part B, provided they meet defined medical necessity criteria.

• Interventional treatments include injections, nerve blocks, and spinal implants, not just general pain medications.
• Procedures may be diagnostic or therapeutic, with some covered only when used to confirm a pain source.
• Medicare Part B covers outpatient procedures, while inpatient stays are handled under Part A.

Because many interventional pain procedures involve imaging, anesthesia, and highly specialized providers, Medicare also requires that the facility and physician meet specific qualification standards.

Medicare Part B Coverage Requirements

Once your deductible is met, Medicare Part B covers 80% of the cost for medically necessary outpatient interventional procedures. However, patients are still responsible for 20% coinsurance—unless they have a Medigap policy or other supplemental coverage.

• Annual Part B deductible for 2025 is $257, after which Medicare covers 80% of approved costs.
• Beneficiaries are responsible for 20% coinsurance, which can range from $200 to over $2,000 depending on the procedure.
• Prior authorization is required for many interventional treatments, especially high-cost procedures like spinal cord stimulation.
• Only qualified, Medicare-approved providers and facilities can perform covered pain procedures.

Before approving coverage, Medicare reviews medical necessity, provider certification, prior treatment attempts, and diagnostic findings. Any gaps in documentation can delay or prevent approval.

Medical Necessity Standards for Pain Procedures

To be covered by Medicare, interventional pain procedures must meet strict medical necessity standards. That means the pain must be chronic, functionally limiting, and unresponsive to conservative therapies like physical therapy, acupuncture, or behavioral health integration services.

• Documented failure of conservative treatments such as physical therapy or non-opioid treatment for chronic pain is required.
• Accepted diagnoses include spinal stenosis, radiculopathy, CRPS, and myofascial pain, among others.
• Detailed assessment of functional limitations (walking, lifting, sleeping, etc.) is necessary.
• Providers must evaluate contraindications, expected outcomes, and clearly document treatment goals.

Medical records should clearly show why conservative therapies were insufficient and why the proposed procedure is the next appropriate step. Many patients benefit from support during this stage to help track, gather, and submit the right documentation—which is where a Solace advocate can make a real difference.

Common Medicare-Covered Interventional Pain Procedures

Medicare covers a wide range of interventional procedures when they are performed by qualified providers and all documentation requirements are met. These treatments are designed to offer more precise, lasting relief than systemic medications and are often used as alternatives to chronic opioid therapy. Below are the most commonly covered categories, including what’s required to qualify.

Epidural Steroid Injections

Epidural steroid injections are one of the most frequently used procedures for spinal pain. They deliver anti-inflammatory medication directly around nerve roots to reduce swelling and ease symptoms caused by spinal conditions.

Coverage Criteria and Requirements

• Diagnosis must include spinal stenosis, herniated discs, or radiculopathy, confirmed through imaging.
• Prior conservative treatment must be documented, including physical therapy and medication trials.
• Imaging (usually MRI or CT) must support the injection’s target area and approach.
• Only certain specialists can perform injections, such as pain management doctors, anesthesiologists, or orthopedic surgeons.

Medicare limits how often these injections can be performed—usually no more than three to four times per year per region of the spine.

Types of Epidural Injections Covered

• Lumbar injections for lower back and leg pain due to nerve compression.
• Cervical injections to manage pain radiating to the arms and shoulders.
• Thoracic injections for mid-back discomfort, though less common.
• Caudal and transforaminal approaches are often covered with documentation.
• Interlaminar injections may also be approved based on clinical need.

No matter the type, coverage depends on medical necessity, anatomical correlation, and a well-documented response to prior treatments.

Facet Joint Injections and Radiofrequency Ablation

Facet joint injections target the small joints that stabilize the spine. When arthritis or degeneration inflames these joints, they can cause chronic, localized pain. Medicare also covers radiofrequency ablation (RFA), which uses heat to deactivate nerves that transmit pain from these joints.

Facet Joint Injection Coverage

• Facet joint arthritis must be clearly documented through imaging and exam findings.
• Initial diagnostic injections are typically required first to confirm the pain source.
• Follow-up therapeutic injections may be approved if diagnostic blocks show significant relief.
• Conservative treatment attempts like physical therapy must be documented.

Facet injections are usually performed under fluoroscopy and must target specific levels and sides of the spine, with limitations on how many can be performed per session.

Radiofrequency Ablation (RFA) Coverage

• Medicare requires at least one or two diagnostic blocks first, with 50–80% pain relief.
• Covered for cervical, thoracic, or lumbar spine, when facet-related pain is confirmed.
• Documentation must include expected benefits, such as reduced opioid use or improved mobility.
• Repeat RFA may be allowed, typically every 6 to 12 months if symptoms recur.

Like injections, RFA must be done by qualified providers in appropriately equipped facilities, with clear documentation of outcomes and functional goals.

Trigger Point Injections

Trigger point injections are used to treat myofascial pain syndrome and other chronic muscle pain conditions. They work by relaxing muscle knots and relieving referred pain patterns.

Coverage Requirements

• Diagnosis must include myofascial pain or chronic muscle pain, confirmed on physical exam.
• Trigger points must be documented as palpable, reproducible sources of pain.
• Physical therapy and medication trials should precede injections and be noted in the record.
• Limitations exist on how many trigger point areas can be treated per session, often capped at three to four.

These injections are sometimes performed with anesthetic only, or combined with corticosteroids, depending on the provider’s clinical judgment and the patient's response.

Injection Site and Technique Coverage

• Coverage may apply to single or multiple injection sites, depending on diagnosis and documentation.
• Common anatomical areas include trapezius, gluteal, and paraspinal muscles.
• Steroid or anesthetic injections are covered, but dry needling is not under Medicare.
• Documentation of results and ongoing treatment plan is critical for continued coverage.

Trigger point injections are generally used as part of a larger chronic pain management and treatment services plan, and are best supported by concurrent therapies like physical therapy or behavioral health integration services.

Sympathetic Nerve Blocks

Sympathetic nerve blocks are used to manage pain syndromes involving the autonomic nervous system, especially Complex Regional Pain Syndrome (CRPS). These blocks can both diagnose and treat certain types of pain, particularly when standard therapies haven’t worked.

Stellate Ganglion Blocks

• Used for CRPS and neuropathic pain affecting the upper extremities, including post-surgical pain and trauma.
• Initial diagnostic block required, followed by therapeutic blocks if pain is relieved.
• Treatments are usually done in a series, with required spacing between sessions.
• Medicare covers these when documentation shows sympathetic nervous system involvement and failure of conservative treatment.

Patients must have detailed clinical notes supporting diagnosis, failed prior treatment, and sustained benefit from early blocks to justify repeat procedures.

Lumbar Sympathetic Blocks

• Used for CRPS in the legs, phantom limb pain, or vascular insufficiency-related discomfort.
• Clinical records must confirm diagnosis, with objective signs like temperature change or color change in the limb.
• Conservative measures like physical therapy, medication, or behavioral strategies must be documented.
• Repeated procedures must show prior benefit, with reassessment after each block.

Sympathetic blocks are considered advanced pain management interventions and are generally provided by anesthesiologists or board-certified pain specialists in hospital outpatient departments or specialized pain clinics.

Spinal Cord Stimulation

Spinal cord stimulation (SCS) delivers electrical impulses to the spinal cord to block pain signals before they reach the brain. Medicare covers both the trial period and permanent implantation—but only after all conservative and interventional options have been exhausted.

Trial Stimulation Coverage

• Strict guidelines require documentation of chronic pain for at least 6 months, especially following back surgery or with radicular pain.
• Patients must have tried conservative treatments such as physical therapy, prescription medications, or non-opioid treatment for chronic pain.
• A psychological evaluation is mandatory, to assess for depression, anxiety, and readiness for implant.
• Trial success—usually defined as 50% or greater pain reduction—is required before permanent implantation.

Documentation must detail functional goals, current limitations, and how SCS is expected to improve quality of life or reduce medication reliance.

Permanent Implant Coverage

• Only covered after a successful trial, with clear documentation of symptom relief and functional improvement.
• Providers must track changes in medication use, pain scores, and daily activity capacity.
• Coverage includes follow-up visits, programming, and long-term monitoring.
• Battery replacement and hardware maintenance are covered, though they may require separate authorization.

SCS is one of Medicare’s most tightly regulated chronic pain treatments—but it’s also one of the most effective when used for the right conditions with a strong supporting care plan.

Step-by-Step Process for Getting Procedure Coverage

Successfully receiving Medicare-covered interventional pain treatment involves three key phases, each requiring specific documentation and coordinated care. A Solace advocate can help patients navigate these stages and submit the information needed for approval.

Phase 1: Conservative Treatment Documentation (Months 1–6)

Before any interventional pain procedure is covered, Medicare requires a trial of conservative care. This usually means a combination of therapies, medications, and provider follow-up over several months.

1. Comprehensive Pain Evaluation
   • Pain scale ratings, physical exams, and imaging (MRI/CT) linking symptoms to diagnoses.
   • Functional assessment showing limitations in daily life or work.
   • Sleep disruption, fatigue, and quality of life impacts recorded in clinical notes.
   • Evaluations from physical therapy, occupational therapy, or behavioral health integration services.
2. Conservative Treatment Trials
   • Physical therapy with defined goals and progress reports over 4–6 weeks.
   • Medication trials, including non-opioid treatments or prescription pain medications, with outcome tracking.
   • Lifestyle or activity modifications such as weight loss, bracing, or ergonomic adjustments.
   • Other alternatives, like acupuncture for chronic low back pain or chiropractic services, if relevant and documented.

This phase is critical to establish the baseline—and justify why more invasive treatment is necessary. Insufficient documentation here is a leading reason for denial.

Phase 2: Specialist Referral and Evaluation (Weeks 1–4)

Once conservative treatment is documented and fails to offer relief, patients should be referred to a Medicare-credentialed pain management specialist.

1. Pain Management Consultation
   • Detailed review of all prior therapies and diagnostic work.
   • Identification of interventional options appropriate to the condition and treatment goals.
   • Risk evaluation and screening for conditions like opioid use disorder or contraindications to interventional procedures.
   • Development of a treatment plan with timelines and expected benefits.
2. Procedure-Specific Evaluation
   • Confirming diagnosis with imaging, physical exam, and specialist interpretation.
   • Counseling the patient on benefits, risks, and next steps.
   • Informed consent for the proposed procedure, trial period, or diagnostic injection.
   • Documentation to begin the prior authorization process, including summary letters from the provider.

Having a specialist review the full record and sign off on medical necessity significantly strengthens the case for Medicare approval.

Phase 3: Prior Authorization and Procedure (Weeks 2–6)

Once the procedure plan is finalized, the prior authorization process begins. For Medicare Advantage plans, this step is usually mandatory. While Original Medicare may not always require pre-approval, providers often submit documentation in advance to avoid denials.

1. Prior Authorization Process
   • Submission of all medical records, including conservative treatment history, diagnostic imaging, and functional assessments.
   • Detailed specialist notes explaining why the procedure is medically necessary.
   • Provider responses to insurance follow-up questions, often within a tight window.
   • Timeline monitoring to prevent lapsed approvals or scheduling delays.

A Solace advocate can help gather, organize, and expedite this paperwork, reducing administrative back-and-forth and improving approval odds.

1. Procedure Scheduling and Performance
   • Appointment is scheduled at a Medicare-approved facility, with credentialed providers.
   • Patient receives education, prep instructions, and post-procedure care plans.
   • Procedure is performed with appropriate monitoring and documentation.
   • Follow-up visit scheduled to evaluate outcomes, assess complications, and plan next steps.

Proper records of how the patient responds will also be used to justify future procedures or repeat treatments.

Documentation Requirements for Procedure Coverage

Medicare evaluates not just the proposed procedure but also the quality and completeness of supporting documentation. Missing or incomplete records are among the most common reasons for claim denials.

Conservative Treatment Documentation

Physical Therapy Requirements

• Minimum of 4–6 weeks of therapy, with goal-setting and outcome summaries.
• Notes on patient participation, missed appointments, and effort level.
• Therapist evaluation of progress or plateau, with referrals as needed.
• Functional improvement benchmarks—mobility, pain level, endurance, etc.

Medication Trial Documentation

• Names, dosages, and duration of medications (e.g., NSAIDs, muscle relaxants).
• Any side effects, contraindications, or discontinuation reasons.
• Effectiveness tracking and functional impact notes.
• Rationale for avoiding opioids or enrolling in drug management programs or opioid use disorder treatment services, if applicable.

Thorough documentation demonstrates medical necessity and compliance with Medicare coverage criteria.

Diagnostic Imaging Requirements

MRI and CT Scan Documentation

• Direct correlation between imaging results and symptoms.
• Clear anatomical targets for interventional procedures.
• Radiologist reports identifying structural causes of pain.
• Imaging recency—studies must reflect current condition, not past injuries.

Electrodiagnostic Testing

• EMG or nerve conduction study (NCS) results pinpointing nerve dysfunction.
• Specialist interpretation matching clinical symptoms.
• Testing used to confirm or guide treatment selection (e.g., spinal cord stimulation).
• Notes on persistent abnormalities or progression over time.

These tests help validate that interventional approaches are justified and appropriately chosen.

Functional Assessment Documentation

Activities of Daily Living Impact

• Specific limitations: walking, dressing, lifting, sleeping, driving.
• Job or caregiving duties affected by chronic pain.
• Inability to engage in social or recreational activities.
• Documented goals for returning to function post-procedure.

Pain Scale and Quality of Life Measures

• Consistent 0–10 pain ratings across visits and providers.
• Use of quality-of-life surveys or tools (e.g., Oswestry Disability Index).
• Impact of pain on mood, sleep, and independence.
• Screening for depression or anxiety related to pain condition.

These measures help Medicare understand the human impact—not just the physical diagnosis.

Medicare Advantage vs. Original Medicare for Pain Procedures

Both Medicare Advantage (Part C) and Original Medicare cover interventional pain procedures—but with key differences in process and access.

Original Medicare Considerations

• Uniform coverage criteria nationwide, based on CMS guidelines.
• Freedom to choose any Medicare-approved specialist without network restrictions.
• Standard prior authorization and appeals process, handled by providers.
• Easier to coordinate care across different providers and facilities.

Original Medicare offers more flexibility, but you may need a Medigap plan to reduce out-of-pocket costs.

Medicare Advantage Plan Variations

• Network limitations may affect provider choice and facility access.
• Some plans offer enhanced pain management coverage, like acupuncture or integrated behavioral services.
• Prior authorization rules vary by plan, even for the same procedure.
• Many Advantage plans offer care coordination for chronic pain management, including nurse case managers or digital support tools.

It’s critical to check the fine print of your plan—or have a Solace advocate walk you through it.

Common Coverage Challenges and Solutions

Even medically appropriate procedures can be denied if the paperwork doesn’t match Medicare expectations. These are the most common issues we see—and how to fix them.

Frequent Reasons for Procedure Denials

• Missing documentation of conservative treatments like physical therapy or chiropractic services.
• Imaging results that don’t match the proposed procedure site or diagnosis.
• No clear record of functional impairment or how pain affects daily life.
• Lack of evaluation from a qualified pain management specialist.
• Incorrect CPT codes or billing submissions.

Every denied claim is a chance to identify gaps and resubmit with better documentation.

Strengthening Prior Authorization Applications

• Detailed notes from physical therapists, specialists, and primary care providers.
• Imaging clearly labeled and linked to the treatment plan.
• Functional goals that show how the patient expects to improve.
• Letters from specialists supporting the procedure, especially when prior treatments failed.
• Citations from evidence-based literature when the procedure isn’t routinely approved.

A strong application doesn’t just state facts—it tells a cohesive story.

Appeal Strategies for Denied Procedures

Level 1: Redetermination

• Submit missing documents and expanded notes from treating providers.
• Add letters from pain specialists or second opinions.
• Include patient surveys, function reports, or ADL impact logs.
• Reference clinical trials or guidelines showing efficacy of the procedure.

Higher Level Appeals

• Request an independent medical exam (IME) from a pain specialist.
• Include expert testimony or written statements.
• Point to similar Medicare cases or national coverage determinations.
• Partner with an advocate to meet deadlines, fill gaps, and present a compelling case.

Managing Costs and Financial Considerations

Even with Medicare, chronic pain procedures can carry financial risks. Knowing how charges break down—and where help is available—can ease the burden.

Medicare Cost Breakdown for Pain Procedures

Even with Medicare, chronic pain procedures can carry financial risks. Knowing how charges break down—and where help is available—can ease the burden.

Medicare typically covers 80% of the approved amount for outpatient interventional pain procedures after you meet the Part B deductible. But that remaining 20% coinsurance can include multiple components depending on where and how your treatment is delivered:

Knowing what each component costs allows you to plan ahead and ask about bundled billing or coverage options.

Financial Planning for Interventional Pain Treatment

Insurance Coordination

Understanding your full insurance picture can save you from unexpected bills and coverage gaps. If you have Original Medicare, a Medigap plan can help cover that 20% coinsurance that adds up quickly with repeated procedures. Medicare Advantage plans often work differently, with set copays instead of coinsurance—which might be better or worse for your situation, depending on how much treatment you need.

Don't forget about other coverage you might have. If your pain stems from a work-related injury, workers' compensation could step in to cover procedures that Medicare might not. The key is reviewing all your active insurance before treatment starts to avoid those frustrating moments when providers can't figure out who pays what.

Payment Options and Assistance

Even with good insurance, interventional pain procedures can strain your budget. Many hospitals offer financial assistance programs, especially helpful when you're facing multiple procedures over time. These programs often have income requirements, but they're worth exploring—some can reduce your bills significantly or set up manageable payment plans.

Payment plans arranged directly with your provider or facility can spread costs over months instead of hitting you with one large bill. For device-based procedures like spinal cord stimulators, the manufacturer sometimes offers support programs to help with costs.

If standard coverage isn't available, clinical trial participation might be an option. You'd get cutting-edge treatment at reduced cost while contributing to research that helps other pain patients.

Solace advocates can also help identify these options—and advocate for the least burdensome financial path.

Long-term Management and Follow-up Care

Here's something important that often gets overlooked: interventional pain procedures are rarely one-and-done. The real work happens in the weeks and months afterward, with ongoing monitoring, goal setting, and care coordination making all the difference between temporary relief and lasting improvement.

Post-Procedure Monitoring and Documentation

Your pain journey doesn't end when you leave the procedure room. Tracking your pain scores over time helps your team assess whether the treatment is actually working. But numbers only tell part of the story—you'll also want to document changes in your physical function, medication use, and daily activities.

This ongoing documentation serves multiple purposes. It helps your care team adjust your treatment plan, supports insurance coverage for future procedures, and prevents gaps in care when you switch providers or move. Don't underestimate the importance of monitoring for complications either, whether that's signs of infection, medication reactions, or the gradual return of pain that signals the procedure's effects are wearing off.

Ongoing Pain Management Coordination

Effective pain management requires teamwork, and that means keeping everyone on the same page. Your pain specialist needs to communicate with your primary care doctor, and both need to stay connected with any physical therapists, occupational therapists, or behavioral health providers on your team.

This coordination becomes especially important as your treatment evolves. Maybe you're finally able to reduce your opioid medications, or perhaps you're ready to add behavioral therapy to address the anxiety that often accompanies chronic pain. Some patients benefit from medication therapy management programs that help optimize their drug regimens, while others need access to social support or caregiver resources.

Remember, pain management isn't just about reducing symptoms—it's about rebuilding your life and reclaiming the activities that matter to you.

How a Solace Healthcare Advocate Can Help with Pain Procedure Coverage

Even with a solid care team, navigating Medicare coverage for pain procedures can feel like its own kind of torture. The paperwork alone is enough to worsen anyone's stress levels. Solace advocates step in to handle the bureaucratic burden so you can focus on what really matters: getting better.

Pre-Authorization and Documentation Support

Before you can get treatment, someone needs to prove to Medicare that you actually need it. This means gathering treatment records, diagnosis documentation, and evidence that less invasive options have been tried. Your advocate can review all these records for gaps or inconsistencies that might trigger a denial, then work with your providers to complete and organize the required documentation.

They'll also help write and submit prior authorization packets, making sure everything meets Medicare's specific criteria. Since different procedures fall under different parts of Medicare with different rules, having someone who understands these distinctions can mean the difference between approval and denial.

Provider Network Navigation

Finding the right pain specialist isn't just about medical expertise—you need someone who accepts Medicare, has reasonable wait times, and actually listens to your concerns. Your advocate can help you research qualified, in-network specialists, looking at factors like patient satisfaction scores and accessibility for people with mobility limitations.

When your care involves multiple providers—maybe a pain specialist, a facility for procedures, and various therapists—your advocate coordinates between all these moving parts to keep your treatment plan on track. They can also help secure referrals for complementary treatments like chiropractic services, acupuncture, or behavioral therapy when those might help your overall pain management strategy.

Claims Management and Appeals

When Medicare denies coverage for a procedure you and your doctor believe is necessary, it's not the end of the road—but it is the beginning of a paperwork marathon. Your advocate can review denied claims to identify exactly what evidence Medicare found lacking, then draft appeal letters and organize supporting records to address those specific concerns.

Sometimes this means securing second opinions or expert recommendations to strengthen your case. Your advocate tracks all the appeal timelines and submission windows, making sure nothing gets missed due to bureaucratic deadlines.

Comprehensive Pain Management Coordination

Beyond just fighting for coverage, Solace advocates help integrate interventional procedures into your broader, long-term care plan. They can assist with setting realistic recovery goals, managing expectations about what different procedures can and can't accomplish, and optimizing coverage across Medicare and any supplemental plans you have.

They also connect you with resources that insurance doesn't always cover but that can make a huge difference in your quality of life—social workers who specialize in chronic pain, peer support groups, and community-based chronic pain management services.

Solace advocates are covered by Medicare, which means getting this level of support doesn't add to your financial burden. They don't just fight for your coverage—they become partners in your long-term recovery.

FAQ: Frequently Asked Questions About Medicare Pain Procedure Coverage

What pain procedures does Medicare typically cover?

Medicare covers epidural steroid injections, facet joint injections, radiofrequency ablation, trigger point injections, sympathetic nerve blocks, and spinal cord stimulation when medical necessity criteria are met.

How long do I need to try conservative treatments before Medicare will cover pain procedures?

Medicare typically requires 3–6 months of conservative treatment including physical therapy and medications, though specific requirements vary by procedure and condition.

Do I need a referral to see a pain management specialist for Medicare-covered procedures?

While Original Medicare doesn't require referrals, you'll need documentation of conservative treatment failure and medical necessity. Some Medicare Advantage plans may require referrals.

How much will I pay out-of-pocket for Medicare-covered pain procedures?

After meeting your Part B deductible ($257 in 2025), you'll pay 20% of the Medicare-approved amount. Costs vary by procedure, typically ranging from $200–$2,000+ out-of-pocket.

What should I do if Medicare denies coverage for a pain procedure?

You can appeal through Medicare's appeals process. Often, additional documentation of conservative treatment failure or medical necessity can result in coverage approval.

How often can I get repeated pain procedures through Medicare?

Frequency depends on the specific procedure and your response. For example, epidural injections may be limited to 3–4 per year, while radiofrequency ablation may be repeated when pain returns.

Does Medicare cover spinal cord stimulators for chronic pain?

Yes, Medicare covers spinal cord stimulator trials and permanent implants for qualifying conditions like failed back surgery syndrome, but requires strict documentation of conservative treatment failure.

Can Medicare Advantage plans provide different coverage for pain procedures?

Yes, Medicare Advantage plans may have different prior authorization requirements, network restrictions, or enhanced coverage, but must cover the same basic services as Original Medicare.

This article is for informational purposes only and should not be substituted for professional advice. Information is subject to change. Consult your healthcare provider or a qualified professional for guidance on medical issues, financial concerns, or healthcare benefits.

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