Updated analysis of decline of 16.8% in utilization of interventional pain management techniques among traditional (fee-for-service) medicare beneficiaries from 2019 to 2024

Authors

Laxmaiah Manchikanti, Pain Management Centers of America, Paducah, KY; Departments of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY; Department of Anesthesiology, School of Medicine, LSU Health Science Center, New Orleans, LA.
Vidyasagar Pampati, Pain Management Centers of America, Paducah, KY.
Mahendra Sanapati, Department of Anesthesiology and Perioperative Medicine, University of Louisville School of Medicine, Louisville, KY; Indiana University School of Medicine, Evansville, IN.
Nebojsa Nick Knezevic, Advocate Health - MidwestFollow
Alan D. Kaye, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, Tulane School of Medicine and LSU School of Medicine, New Orleans, LA.
Amol Soin, Ohio Pain Clinic, Dayton, OH; Wright State University, Dayton, OH.
Alaa Abd-Elsayed, UW Health Pain Services and University of Wisconsin, Madison, WI.
Joshua A. Hirsch, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Recommended Citation

Manchikanti L, Pampati V, Sanapati M, et al. Updated Analysis of Decline of 16.8% in Utilization of Interventional Pain Management Techniques Among Traditional (Fee-for-Service) Medicare Beneficiaries from 2019 to 2024. Pain Physician. 2025;28(S7):S121-S136.

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Background: In recent years, rising costs associated with managing spinal pain and other musculoskeletal disorders have been well documented. Prior to the COVID-19 pandemic, the use of interventional techniques to manage spinal pain and other musculoskeletal disorders had steadily increased. However, the pandemic disrupted chronic pain management, including interventional procedures and opioid use, reflecting a broader reduction in healthcare services.

Objectives: To provide an updated assessment of interventional technique utilization for chronic pain management in the U.S. Medicare population from 2000 to 2024.

Study design: Retrospective cohort study examining trends and factors influencing interventional technique use for chronic pain management within the traditional fee-for-service (FFS) Medicare population in the United States between 2000 and 2024.

Methods: Data were obtained from the Centers for Medicare & Medicaid Services (CMS) master database, specifically the physician/supplier procedure summary, covering the years 2000 through 2024.

Results: Service rates for interventional pain management per 100,000 Medicare beneficiaries significantly declined by 16.8% cumulatively from 2019 to 2024, corresponding to an average annual decrease of 3.6%. This contrasts with the 2010-2019 period, during which a cumulative increase of 14.5% was observed, along with an average annual growth rate of 1.5%. The steepest decline occurred between 2019 and 2020, with a 15.4% reduction coinciding with the onset of the COVID-19 pandemic.

Limitations: The analysis is limited to traditional (FFS) Medicare beneficiaries, excluding Medicare Advantage Plans, which represented nearly 54% of Medicare enrollment in 2024. Additionally, as with all retrospective claims-based studies, inherent limitations of coding accuracy and incomplete clinical detail apply.

Conclusion: From 2019 to 2024, the use of interventional pain management techniques declined significantly. Contributing factors likely include the lingering effects of COVID-19, economic pressures, the Affordable Care Act, and evolving local coverage determination (LCD) policies.

Type

Article

PubMed ID

41481870