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 16, 2026
We identified it
Jun 17, 2026
Summary
New Local Coverage Determination L38994 for epidural steroid injections for pain management has been established by Palmetto GBA (Medicare Administrative Contractor). This policy will define coverage criteria, documentation requirements, and billing guidelines for epidural steroid injection procedures under Medicare.
Action Required
By April 16, 2026: Billing team must review and implement the full LCD L38994 requirements for epidural steroid injections. Access the complete policy at cms.gov/medicare-coverage-database to identify specific CPT codes, coverage criteria, and documentation requirements. Update billing system rules and provider documentation templates accordingly. Failure to comply may result in claim denials for epidural steroid injection procedures.