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Peripheral Nerve Stimulation Is Medically Necessary and Clinically Validated and Can No Longer Be Deemed Experimental

  • Peter S. Staats
  • , Timothy Deer
  • , Sean Li
  • , Konstantin Slavin
  • , Sayed Wahezi
  • , Miles Day
  • , Paul Christo
  • , Jason S. Eldridge
  • , Steven P. Cohen
  • , Jennifer Hah
  • , David Dickerson
  • , Hemant Kalia
  • , Robert Levy
  • , Alan D. Kaye
  • , Mahendra R. Sanapati
  • , Laxmaiah Manchikanti

Research output: Contribution to journalArticlepeer-review

Abstract

Peripheral Nerve Stimulation (PNS) is a well-established neuromodulation therapy with decades of clinical use, a substantial body of clinically validated, peer-reviewed evidence, and endorsement in multiple evidence-based professional guidelines, including by the US Department of Defense. Despite this maturity, many commercial payers continue to deny coverage by categorizing PNS as “investigational” or “experimental,” often conflating it with fundamentally different, indirect electrical stimulation modalities. This misclassification is increasingly misaligned with current science, clinical practice, and health-economic data, and has become a primary barrier to patient access to medically necessary care for refractory chronic pain. Given this extensive evidence base, it is no longer appropriate or ethical for payors to deny patients access to such an impactful treatment that clinicians and patients rely upon for managing refractory chronic pain. The present position statement – peripheral nerve stimulation is medically necessary and clinically validated, is developed by consensus of multidisciplinary experts with deep expertise in the field of neuromodulation, chronic pain, and peripheral nerve stimulation. This position statement provides background and rationale showing the justification for the statement supported by literature research and clinical evidence.

Original languageEnglish (US)
Pages (from-to)301-306
Number of pages6
JournalPain physician
Volume29
Issue number5
StatePublished - Jul 1 2026

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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