New Medicare Program: Full List of Services That Will Need Prior Approval [View all]
Source: Newsweek
Published Dec 26, 2025 at 12:39 PM EST updated Dec 26, 2025 at 12:40 PM EST
Medicare is launching a new pilot program that will require prior approval for 17 health services using artificial intelligence tools. The Wasteful and Inappropriate Service Reduction (WISeR) model is launching in six states starting next year. Under the program, health care providers will be required to obtain Medicare approval before patients can access a range of specific services.
Why It Matters
Nearly 70 million seniors rely on Medicare for their health insurance. Historically, traditional Medicare did not require prior authorization, but the new pilot program from the Centers for Medicare & Medicaid Services is adding this requirement for 17 services.
What To Know
The new WISeR model pilot will require prior authorization for 17 services:
Electrical nerve stimulators Sacral nerve stimulation for the treatment of urinary incontinence Phrenic nerve stimulator Deep brain stimulation for the treatment of essential tremor and Parkinson’s disease Vagus nerve stimulation Surgically induced lesions of nerve tracts Hypoglossal nerve stimulation for the treatment of obstructive sleep apnea Epidural steroid injections for pain management, excluding facet joint injections Percutaneous vertebral augmentation Cervical fusion surgery Arthroscopic lavage and arthroscopic debridement for the knees of people with osteoarthritis Incontinence control devices Diagnosis and treatment of impotence Percutaneous image-guided lumbar decompression for spinal stenosis Skin and tissue substitutes Application of bioengineered skin substitutes to chronic non-healing wounds on lower limbs Wound application of cellular/tissue-based products for lower limbs
The pilot will last six years. It begins on January 1, 2026, for those on traditional Medicare in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington.
Read more: https://www.newsweek.com/new-medicare-program-full-list-services-prior-approval-11272518
Need to destroy this AI shit RFN.
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