CMS Issues 2022 PFS, Delays Changes to Pain Coding but Directly Quotes AACIPM Letter

CMS has released the final physician fee schedule for 2022, making updates to Medicare Part B payment policies, coverage of opioid use disorder services furnished by opioid treatment programs, requirements for electronic prescribing for controlled substances for a covered Part D drug under a prescription drug plan, and more.

This release comes on the heels of an open comment period in which CMS requested information from stakeholders related to the healthcare settings and practitioners that furnish non-opioid pain management, the resources involved in treating chronic pain, and how CMS might design new codes that will better enable health providers to classify and treat pain. In response, AACIPM had issued recommendations related to the creation of standalone pain codes, both time-based and value-based, and the need for CMS to ensure that a wide-range of clinicians are able to provide guideline-concordant services. CMS received over 1,900 public comments related to potential separate coding for chronic pain management but delayed making changes, promising to “carefully consider this feedback for future rulemaking.” However, the efforts of AACIPM’s many stakeholders were not for naught, as recommendations #2 and #4 from our letter were directly quoted by CMS in their summary of public comments, as they wrote: One commenter recommended that “CMS establish a multi-stakeholder working group to determine operational details and resource allocation” and requested that CMS “establish a pilot program using innovative payment methodologies.”

AANA Releases New Chronic Pain Management Guidelines, Promotes Integrative Care

The American Association of Nurse Anesthesiology has released new Chronic Pain Management Guidelines intended to support Certified Registered Nurse Anesthetists (CRNAs) in the delivery of safe and effective chronic pain management and treatment. The guidelines strongly support an integrative approach, stating in their introductory paragraph: An interdisciplinary team approach that uses a multidimensional pain strategy and integrates the patient’s unique experiences and perspective may help achieve effective pain management and treatment with the goal to improve the patient’s well-being, functionality, and quality of life.

FDA Authorizes Marketing of Virtual Reality System for Chronic Pain Reduction

The U.S. Food and Drug Administration has recently authorized marketing of EaseVRx, a prescription-use immersive virtual reality system that uses cognitive behavioral therapy (CBT) and other behavioral methods to help with pain reduction in patients 18 years of age and older with diagnosed chronic lower back pain. The prescription device, which is intended for at-home self-use, consists of a VR headset and a controller, along with a “Breathing Amplifier” attached to the headset that directs a patient’s breath toward the headset’s microphone for use in deep breathing exercises. The EaseVRx treatment program consists of 56 VR sessions that are 2-16 minutes in length, which are intended to be used as part of a daily eight-week treatment program. 

Dept. of Veterans Affairs Launches Mindfulness Institute

The U.S. Department of Veterans Affairs has launched the Mindfulness Institute, a new Whole Health program focused on improving the health and well-being of Veterans and Staff, through the promotion of evidence-based Mindfulness Training across the VA Portland Healthcare System. The program aims to improve anxiety, depression, stress, sleep, chronic pain, GI difficulties, blood pressure, quality of life, and self-esteem. While the Mindfulness Institute is based in Portland, Oregon, the resources are available to all via the VA’s website.

National Institute on Aging Releases Consumer Guide on Pain

The NIH has released a resource guide for aging Americans entitled Pain: You Can Get Help. The web portal provides information about acute and chronic pain, attitudes about pain, how to describe pain to health care providers, information about pain specialists, lists of pharmacological and non-pharmacological options for treating pain, and more.