Traditional MedicareCoverageMedium impact
Facet Joint Interventions 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
This is a new Local Coverage Determination (LCD) for facet joint interventions used in pain management, effective April 16, 2026. The policy establishes coverage criteria and requirements for Medicare patients receiving facet joint procedures through Noridian Healthcare Solutions.
Action Required
By April 16, 2026: Review the complete LCD L38801 policy document at the CMS Medicare Coverage Database to identify specific coverage criteria, documentation requirements, and billing guidelines for facet joint interventions. Update billing workflows and provider documentation templates to ensure compliance with the new coverage determination requirements.