Interventional Pain Management (IPM)
Provider Tools
Clinical guidelines can be accessed below. For health plan specific clinical guidelines, CMS guidelines and Local Coverage Determinations (LCDs), educational documents and other information, please log into RadMD.
Clinical Guidelines
Interventional Pain Management Guidelines
Place of Service Policy for Interventional Pain Management
The Place of Service guideline displayed on this page reflects Evolent’s general policy and is provided for reference only. It is not necessarily the standard that will be applied in any particular instance, as the actual criteria applied will depend on the member’s specific benefit plan, the health plan’s definition of medical necessity, relevant evidence-based clinical guidelines, plan-specific guidance, and any applicable regulatory standards. In the event of any conflict between this policy and a health plan’s specific guidance or applicable regulation, the health plan-specific guideline or regulation will always take precedence. Providers should always consult the applicable health plan’s specific Site of Care guidance.
More Documents
Treatment Plan Checklist/Tip Sheet
Conservative Treatment Forms
Conservative Treatment Forms in Spanish