PreClaim
Effective January 1, 2026

CMS just made Medicare prior auth mandatory for pain management.

The WISeR (Wasteful and Inappropriate Service Reduction) Model targets 17 interventional pain procedures across 8 pilot states. If you perform these procedures on traditional Medicare patients, every claim now requires prior authorization.

What is the WISeR Model?

In plain language: CMS reviewed utilization data for interventional pain procedures and decided some regions have higher-than-expected volumes. Their solution is mandatory prior authorization — before you can perform the procedure, you need approval.

This is the first time Medicare FFS has required PA at this scale. It affects an estimated 7,000+ pain management practices in the pilot states. The model runs from 2026 through 2031.

17
Targeted procedures
8
Pilot states
5 yrs
Model duration (2026–2031)

The 17 targeted procedures

Every one of these now requires PA for Medicare FFS in pilot states.

62322
ESI, Cervical/Thoracic
62323
ESI, Lumbar/Sacral
64490
Facet Joint Injection, Cervical 1st Level
64491
Facet Joint Injection, Cervical Add-On
64492
Facet Joint Injection, Cervical 2nd Add-On
64493
Facet Joint Injection, Lumbar 1st Level
64494
Facet Joint Injection, Lumbar Add-On
64495
Facet Joint Injection, Lumbar 2nd Add-On
64625
Radiofrequency Ablation, Sacroiliac
64633
Radiofrequency Ablation, Cervical 1st Level
64634
Radiofrequency Ablation, Cervical Add-On
64635
Radiofrequency Ablation, Lumbar 1st Level
64636
Radiofrequency Ablation, Lumbar Add-On
63650
Spinal Cord Stimulator Trial
63685
Spinal Cord Stimulator Permanent
27096
Sacroiliac Joint Injection
0213T
SI Joint Fusion

Pilot states: Arizona, New Jersey, Ohio, Oklahoma, Texas, Washington, and additional states to be announced.

What this means for your practice

New denial category

Procedures that previously went straight through now require documentation you may not have assembled. Missing PA = automatic denial. No exceptions.

Financial exposure

A typical interventional pain practice performing 60–80 targeted procedures per month faces $150K–$250K in annual exposure from WISeR-related denials alone.

AI review requires AI prep

CMS uses AI-assisted review to evaluate PA requests. Your submissions need to be precise, evidence-complete, and formatted for algorithmic evaluation — not human judgment.

How PreClaim handles WISeR

WISeR Compliance Module

Automatically identifies which appointments require WISeR PA based on CPT code, payer, and state. Flags them in the daily queue with specific documentation requirements.

Impact Analyzer

Shows your total WISeR financial exposure — procedure by procedure. Projects denial risk based on your current documentation patterns.

Conservative Care Ladder Tracking

Maps each patient's conservative care history against WISeR requirements. Shows exactly which escalation steps are documented and which are missing.

Gold Card Pathway

Tracks your PA approval rate toward the ≥90% threshold for gold card exemption. Once qualified, WISeR PA is waived for your facility.

Get your free WISeR Impact Report

Upload your 835 data. We'll show your exact WISeR exposure — which procedures, how many patients, and the projected dollar impact.

Free WISeR Assessment