If you live with long-lasting pain, Medicare Part B covers a monthly service built specifically to help manage it: chronic pain management. It bundles your pain assessment, medications, and care planning into one coordinated benefit, billed once a month. This guide explains who qualifies, what it includes, how your doctor sets it up, and what you pay in 2026.
In This Guide
- What Medicare chronic pain management covers
- Who qualifies for chronic pain management
- How to get chronic pain management
- What Medicare chronic pain management costs
- Does Medicare Advantage cover chronic pain management?
- Frequently asked questions
- Learn More
What Medicare chronic pain management covers
Yes, Medicare covers chronic pain management. Medicare Part B covers chronic pain management and treatment services, sometimes shortened to CPM, for people whose pain is ongoing rather than short-term.Centers for Medicare & Medicaid Services. (n.d.). Medicare Chronic Pain Management Services. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/chronic-pain-management-treatment-services It is a benefit Medicare created effective January 1, 2023, under the Calendar Year 2023 Physician Fee Schedule final rule. Instead of paying for a single procedure, it pays for a coordinated, monthly approach to managing pain over time.
The monthly service is a team-based bundle. Its elements include:Centers for Medicare & Medicaid Services. (n.d.). Medicare Chronic Pain Management Services. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/chronic-pain-management-treatment-services
- A pain assessment, including a validated pain rating scale or tool, to understand your pain and how it affects you.
- Medication management to review and adjust the medicines you take for pain.
- A person-centered care plan that is developed, put into action, and revised over time.
- Care coordination, which ties your pain care together and keeps it connected to the rest of your treatment, including any behavioral health care and chronic-pain crisis care you need.
Because managing chronic pain is an ongoing process rather than a one-time visit, the service is furnished monthly. Your physician or another qualified health care professional, such as a nurse practitioner, physician assistant, or clinical nurse specialist, provides it and bills Medicare for it under two HCPCS codes: G3002 for the first 30 minutes personally furnished in a calendar month, and G3003 for each additional 15 minutes.Centers for Medicare & Medicaid Services. (n.d.). Medicare Chronic Pain Management Services. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/chronic-pain-management-treatment-services
Who qualifies for chronic pain management
To be eligible, you must have chronic pain, which Medicare defines as persistent or recurring pain lasting longer than 3 months.Centers for Medicare & Medicaid Services. (n.d.). Medicare Chronic Pain Management Services. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/chronic-pain-management-treatment-services Short-term pain, such as recovery from a minor injury that resolves quickly, does not fit this benefit.
This service is distinct from a couple of others people sometimes confuse it with. It is not the same as acupuncture, which Medicare covers only for chronic low back pain, and it is different from chronic care management, which is organized around having two or more chronic conditions rather than around pain specifically.Centers for Medicare & Medicaid Services. (n.d.). Medicare Chronic Pain Management Services. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/chronic-pain-management-treatment-services The right service depends on your situation, and CPM is billed separately from those.
How to get chronic pain management
Chronic pain management is not something you apply for through Medicare directly. It is a service your physician or qualified health care professional offers and bills, so getting it starts with a conversation in the exam room.Centers for Medicare & Medicaid Services. (n.d.). Medicare Chronic Pain Management Services. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/chronic-pain-management-treatment-services
- Talk to your doctor about CPM. Tell the provider who manages your pain that you are interested in monthly chronic pain management services, billed under codes G3002 and G3003. Not every practice bills these codes, so it is worth asking directly.
- Agree to the monthly service. Because CPM is furnished on an ongoing monthly basis, your provider will ask you to sign an agreement to receive this set of services each month. You can stop at any time.
- Review your care plan. Your provider prepares a person-centered care plan for you (or your caregiver) that guides your pain treatment and gets revised as your needs change.
If you are not sure whether your current provider offers CPM, you can also call 1-800-MEDICARE (1-800-633-4227) to ask general questions about the benefit before you raise it at your next appointment.
What Medicare chronic pain management costs
Chronic pain management follows the standard Part B cost rules. After you meet the annual Part B deductible, which is $283 in 2026, you pay 20% of the Medicare-approved amount for the monthly service, and Part B covers the other 80%.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles,Centers for Medicare & Medicaid Services. (n.d.). Medicare Chronic Pain Management Services. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/chronic-pain-management-treatment-services
As with most Part B services, supplemental coverage can reduce what you owe. A Medigap policy (Medicare Supplement Insurance) or other supplemental insurance may pick up the 20% coinsurance, and most people who are dually eligible for Medicare and Medicaid are not responsible for the cost-sharing.Centers for Medicare & Medicaid Services. (n.d.). Medicare Chronic Pain Management Services. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/chronic-pain-management-treatment-services
| What to know | |
|---|---|
| Who qualifies | People with chronic pain (persistent or recurring pain lasting longer than 3 months) |
| What it includes | Pain assessment, medication management, care coordination, and a person-centered care plan |
| How it is billed | HCPCS codes G3002 (first 30 minutes/month) and G3003 (each additional 15 minutes) |
| How often | Monthly |
| Your cost | 20% of the Medicare-approved amount after the $283 Part B deductible |
Does Medicare Advantage cover chronic pain management?
If you are on a Medicare Advantage plan (Part C) rather than Original Medicare, you are still covered. Medicare Advantage plans must cover everything Original Medicare covers, so chronic pain management is included.Centers for Medicare & Medicaid Services. (n.d.). Compare Original Medicare & Medicare Advantage - Medicare.gov. medicare.gov. Retrieved Jun 23, 2026, from https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage What can differ is the mechanics: your plan may require you to use in-network providers, may require prior authorization, and sets its own cost-sharing rather than the standard 20% coinsurance.Centers for Medicare & Medicaid Services. (n.d.). Compare Original Medicare & Medicare Advantage - Medicare.gov. medicare.gov. Retrieved Jun 23, 2026, from https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles Check your plan's Summary of Benefits or call the plan directly to confirm which providers can furnish CPM and what you will pay.
Frequently Asked Questions
Does Medicare cover chronic pain management?
Yes. Medicare Part B covers chronic pain management and treatment services for people who have chronic pain, defined as persistent or recurring pain lasting longer than 3 months. It is a monthly, coordinated service rather than a single procedure, and it has been a Medicare benefit since January 1, 2023.
What does chronic pain management include?
The service includes a pain assessment (with a validated pain rating scale), medication management, care coordination, and a person-centered care plan. Together these create an ongoing plan to manage your pain and keep that care connected to the rest of your treatment.
How do I get chronic pain management through Medicare?
Ask the provider who manages your pain whether they offer monthly chronic pain management services, billed under codes G3002 and G3003. If they do, they will ask you to sign an agreement to receive the services each month and will prepare a care plan for you. You can also call 1-800-MEDICARE (1-800-633-4227) with general questions.
How is this different from chronic care management?
Chronic pain management is organized around chronic pain specifically. Chronic care management is organized around having two or more chronic conditions. They are separate Part B services, billed separately, and the right one depends on your situation.
What does chronic pain management cost?
After you meet the $283 Part B deductible in 2026, you pay 20% of the Medicare-approved amount for the monthly service.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles A Medigap policy or other supplemental coverage may cover that share, and people dually eligible for Medicare and Medicaid generally pay nothing.
Learn More
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