April 04, 2024

ACR Partners to Address UnitedHealthcare’s Medical Policy on Ablative Treatment for Spinal Pain

The American College of Radiology® (ACR®) recently partnered with the North American Spine Society (NASS) and five other specialty societies to send a comment letter  to UnitedHealthcare regarding the insurer’s negative coverage policy for basivertebral nerve ablation (BVNA).

The insurer now holds the position that “there is insufficient evidence to establish the safety and efficacy of intraosseous radiofrequency ablation of the basivertebral nerve for treating low back pain.” In the letter, the medical societies stress this position led to inappropriate denial of care for patients and told the insurer there is well-established scientific evidence that supports BVNA as a safe and effective procedure. ACR opposes any coverage policy that denies care where evidence is established and accepted by the medical profession.

To date, all the Medicare Administrative Contractors (MACs) and more than 20 other insurance carriers extend coverage and approve the appropriate use of BVNA. ACR continues to work with commercial payers and MACs to advocate for accurate medical policies that reflect clinical practice and do not delay care for patients. The medical societies hope UnitedHealthcare will consider revising its policy to reflect the evidence and provide coverage accordingly.

The College will continue to monitor any changes to this policy and notify members as needed.

If you have questions or would like more information about spinal pain coverage policies and our collaborative activities, contact Alicia Blakey, ACR Principal Economic Policy Analyst.