Delayed Implementation of Prior Authorization for Medicare WISeR Services
Summary
CMS issued a notice delaying the implementation of prior authorization requirements for two services under the WISeR (Wasteful and Inappropriate Services Reduction) Model: Deep Brain Stimulation for Essential Tremor and Parkinson's Disease (NCD 160.24) and Percutaneous Image-Guided Lumbar Decompression for Spinal Stenosis (NCD 150.13). The original January 1, 2026 implementation date for these services has been postponed. The new implementation date will be announced in a future Federal Register notice.
What changed
CMS published a notice delaying the prior authorization implementation for two WISeR Model services that were originally scheduled to begin January 1, 2026. The delayed services are Deep Brain Stimulation for Essential Tremor and Parkinson's Disease (NCD 160.24) and Percutaneous Image-Guided Lumbar Decompression for Spinal Stenosis (NCD 150.13). The delay allows additional time for operational readiness.
Healthcare providers and Medicare fee-for-service suppliers in selected WISeR model states should continue current practices for these two services. Neither prior authorization nor pre-payment review processes are available for these services until a new implementation date is announced via Federal Register. Providers should monitor for future CMS announcements establishing the new timeline.
Source document (simplified)
Notice
Medicare Program; Delayed Implementation of Certain Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
A Notice by the Centers for Medicare & Medicaid Services on 04/06/2026
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- Public Inspection Published Document: 2026-06616 (91 FR 17282) Document Headings ###### Department of Health and Human Services
Centers for Medicare & Medicaid Services
- [CMS-5056-N2]
AGENCY:
Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS).
ACTION:
Notice.
SUMMARY:
This notice announces a delay in the implementation of two services from the list of Wasteful and Inappropriate Services Reduction (WISeR) model items and services.
DATES:
The notice is effective April 6, 2026.
FOR FURTHER INFORMATION CONTACT:
Kate Blackwell (844) 711-2664, Option 8 or WISeR@cms.hhs.gov.
SUPPLEMENTARY INFORMATION:
I. Background
In the July 1, 2025, Federal Register (90 FR 28749), we published a notice titled “Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model”. The notice announced a 6-year model focused on reducing fraud, waste (including low-value care), and abuse in Medicare fee-for-service (FFS) via the implementation of technology-enabled prior authorization processes for select services. For more detailed information regarding the WISeR Model, see the July 2025 notice (90 FR 28749).
II. Delayed Implementation of Select Services
In the July 2025 notice (90 FR 28751), we specified that the prior authorization process under the model will be implemented in the selected states for the listed items and services with affiliated national coverage decisions (NCDs) or local coverage decisions (LCDs) beginning January 1, 2026. We are delaying implementation of two of the services announced in the July 2025 notice to allow additional time for operational readiness. Implementation of the prior authorization or pre-payment review process for these two services is delayed until a future date that will be announced in a subsequent Federal Register notice. Until the future implementation date is announced, neither the prior authorization nor the pre-payment review processes described in our earlier notice will be available for these services. The two services for which we are delaying implementation of the prior authorization or pre-payment review process are as follows:
- Deep Brain Stimulation for Essential Tremor and Parkinson's Disease (NCD 160.24).
- Percutaneous Image-Guided Lumbar Decompression for Spinal Stenosis (NCD 150.13). The Administrator of the Centers for Medicare & Medicaid Services (CMS), Dr. Mehmet Oz, having reviewed and approved this document, authorizes Chyana Woodyard, who is the Federal Register Liaison, to electronically sign this document for purposes of publication in the Federal Register.
Chyana Woodyard,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2026-06616 Filed 4-3-26; 8:45 am]
BILLING CODE 4120-01-P
Published Document: 2026-06616 (91 FR 17282)
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