APMA advocacy has helped secure an important coverage change to five final Medicare Administrative Contractor (MAC) local coverage determinations (LCDs) for peripheral nerve injections and procedures for chronic pain.
In 2025, proposed policies from five MACs would have limited steroid injections for Morton’s neuroma to a maximum of two per lifetime, per side. APMA’s Advocacy team worked with the Research Committee to evaluate the clinical evidence and develop talking points and resources for CAC representatives. Following coordinated advocacy by APMA, CAC representatives, and state associations, including participation in MAC open meetings and submission of formal comments, the MACs removed the proposed lifetime limit from their final policies. The LCDs for “Peripheral Nerve Injections and Procedures for Chronic Pain” are available here:
The final policies instead limit steroid injections for Morton’s neuroma to one per side, per encounter. This change demonstrates the importance of coordinated advocacy and engagement with MACs throughout the LCD process.