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Procedures Requiring Prior Authorization (Most Payers) PA Best Practices for Pain Management Practices Designate a dedicated PA coordinator who tracks submissions, follow-up timelines, and appeal deadlines Build payer-specific PA checklists for your top 5–8 procedures and update them quarterly Document the “medical necessity narrative” in the patient chart before submitting the PA — this is your best defense against denials When denied, request the clinical criteria used for denial (required under most state laws and the No Surprises Act) and respond with peer-reviewed literature supporting the procedure Use peer-to-peer calls proactively for high-cost procedures rather than waiting for denial Telehealth & Remote Patient Monitoring in Pain Management Telehealth permanently expanded the scope of billable pain management services following the COVID-19 Public Health Emergency (PHE)
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