Feds Finalize Rule to Improve NSA Dispute Resolution Access
The U.S. Departments of the Treasury, Labor and Health and Human Services released a final rule May 28 that outlines rules related to the federal independent dispute resolution (IDR) process initiated by the No Surprises Act (NSA). ACR® created a preliminary summary of the rule.
Read moreACR CEO Challenges US House Lawmakers to Pass ROOT Act
ACR®️ CEO Dana H. Smetherman, MD, MPH, MBA, FACR, urged Congress to advance the Radiology Outpatient Ordering Transmission (ROOT) Act (HR 5737) at a May 20 U.S. House subcommittee meeting.
Read moreACR Leaders Recognized at CRCPD 2026 Annual Meeting
ACR® recently participated in the National Conference on Radiation Control organized by the Conference on Radiation Control Program Directors (CRCPD).
Read moreACR® recently joined a webinar hosted by the AMA featuring the CMS Innovation Center (CMMI) about the upcoming Wasteful and Inappropriate Service Reduction (WISeR) Model, a six-year voluntary initiative.
Effective Jan. 1, CMS will implement the WISeR Model in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington. This initiative targets select services under Medicare Part A and Part B that are vulnerable to fraud, waste and abuse.
CMMI confirmed the WISeR Model will launch Jan. 1 and will not be delayed due to the federal government shutdown. Some of the services selected directly impact the College’s interventional radiology members.
Service Category |
Associated NCD/LCDs |
CPT/HCPCS Codes |
| Percutaneous Image-Guided Lumbar Decompression for Spinal Stenosis | NCD 150.13 | 0275T, G0276 |
| Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee | NCD 150.9 | 29877 |
| Induced Lesions of the Nerve Tracts | NCD 160.1 | 64605, 64610 |
| Vagus Nerve Simulator | NCD 160.18 | 64568 |
| Phrenic Nerve Simulator | NCD 160.19 | 33276, 33277 |
| Electrical Nerve Simulators | NCD 160.7 | 63655 |
| Incontinence Control Devices | NCD 230.10 | 53445, 53451, 53452, 53440, 57288 |
| Sacral Nerve Simulators for Urinary Incontinence | NCD 230.18 | 64561, 64581 |
| Diagnosis and Treatment of Impotence | NCD 230.4 | 54400, 54401, 54405 |
| Percutaneous Vertebral Augmentation for Vertebral Compression Fracture | L34106, L38201, L35130 | 22510, 22511, 22512, 22513, 22514, 22515 |
| Epidural Steroid Injections for Pain Management | L39015, L39240, L36920 | 62321, 62323, 64479, 64480, 64483, 64484 |
| Cervical Fusion | L39741, L39758, L39793 | 22554, 22585 |
| Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea | L38307, L38312, L38385 | 64582 |
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Skin and Tissue Substitutes
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Abe Sutton, Director of CMMI, confirmed the model does not change physician payments for services selected for prior authorization under the model; providers can decide not to submit prior authorization requests and claims will be subject to pre-payment medical review.
CMMI reiterated the WISeR Model will be evaluated based on accuracy and timeliness of prior authorization determinations, appeal rates for denied claims, provider and patient experience feedback and performance metrics for WISeR vendors, including processing speed; vendors may be removed if determinations are consistently delayed.
WISeR vendors will typically issue a coverage determination to the Medicare physician within three days of receiving the initial or resubmitted prior authorization request. For prior authorizations that require expedited review, a coverage decision will be provided to the Medicare physician within two days. CMS will also explore Gold Carding in mid-2026 to exempt providers with a high rate of approved requests from pre-payment review.
Radiology practices in affected states should begin preparing for documentation and workflow changes. For full details, refer to the WISeR Provider and Supplier Guide. Radiology practices should review and ensure compliance to avoid payment delays or denials.
Radiology providers in these states should be aware of the following:
For more information about the Wiser Model or questions, contact Alicia Blakey, ACR Principal Economic Policy Analyst.
