Does Medicare cover pain management?

Yes, we accept Medicare

Original Medicare — the red, white and blue card — is accepted at all of our clinics. Medicare Part B covers outpatient care, which is where interventional pain management lives: office visits, image-guided injections and the nerve procedures our physicians perform.

We also accept Medicare Advantage plans from UnitedHealthcare, Anthem, Aetna, Cigna and Humana, each as its own contract. An Advantage plan replaces Original Medicare rather than adding to it, and its rules — copays, referrals, prior authorizations — are the plan's own, which is why we verify them before your first visit.

What Medicare typically covers for pain care

Most Medicare coverage includes interventional pain management when it is medically necessary — the evaluations, image-guided injections and nerve procedures that make up our core work. That typically includes care such as epidural steroid injections, medial branch blocks, radiofrequency ablation and spinal cord stimulation for conditions like back pain, neck pain, sciatica and arthritis. An Advantage plan applies its own rules on referrals and prior authorization, so whichever Medicare you carry, we confirm your coverage before your first visit.

Original Medicare or Medicare Advantage — what changes for you

With Original Medicare, you can generally see any provider who accepts Medicare, and a Medigap supplement, if you carry one, picks up after Medicare pays its share. Bring both cards.

With a Medicare Advantage plan, your plan manages your care: some require a referral, most require prior authorization for procedures, and your costs follow the plan's own schedule. We check all of that during verification and handle the paperwork for you.

Prior authorization

Medicare Advantage plans commonly require prior authorization for interventional procedures, and Original Medicare applies medical-necessity criteria to care such as spinal cord stimulation. Our team finds out what your coverage requires during verification and handles the request, so an authorization step does not hold up your care.

What you can expect to pay

What you pay depends on how you carry Medicare — Original with or without a supplement, or an Advantage plan with its own copay schedule. That is what our verification covers — when we confirm your benefits we tell you what your plan pays and what you can expect to owe, in plain numbers, before you are seen.

How we verify your Medicare benefits

Request verification with your name and phone number, have your Medicare card handy, and our insurance team will confirm your coverage directly with your plan and call you back before your first visit.

Where you can be seen

Once your coverage is verified, you can be seen at our Georgia clinics in Dalton and Ringgold, or at Cleveland, Farragut and Oak Ridge. Procedures that are better done in a dedicated surgical setting may be scheduled at our ambulatory surgery centers in Dalton or Cleveland — your care team will tell you if that applies to you.

Common Medicare questions