Traditional MedicareCoverageHigh impact
Epidural Steroid Injections for Pain Management
Medicare/CMS - LCD·Pain Management, PM&R (Physical Medicine & Rehab), Orthopedics +2 more·Local Coverage Determination
Effective date
Apr 9, 2026
We identified it
Jun 17, 2026
Summary
A new Local Coverage Determination for Epidural Steroid Injections for Pain Management has been issued by Novitas Solutions (Medicare contractor). This policy establishes coverage criteria and billing requirements for epidural steroid injection procedures under Medicare.
Action Required
By April 9, 2026: Billing team must review the complete LCD L36920 policy text from CMS to identify specific CPT codes, coverage criteria, and documentation requirements for epidural steroid injections. Update billing system with any new prior authorization requirements and medical necessity criteria. Train providers on documentation standards to ensure claim compliance.