What is the NOPAIN Act?
The NOPAIN (Non-Opioids Prevent Addiction in the Nation) Act was enacted to expand access to non-opioid pain treatments for Medicare patients to help reduce opioid use and combat the opioid epidemic. It requires that qualifying non-opioid treatments be provided additional, separate reimbursement under Medicare when used in ambulatory surgical center (ASC) or hospital outpatient department (HOPD) settings.
How the NOPAIN Act impacts iovera°
As of January 1, 2025, under a final rule from Centers for Medicare and Medicaid Services (CMS), iovera° is officially recognized as a “qualifying non-opioid device” eligible for separate Medicare reimbursement under the NOPAIN Act.
- Hospitals and ambulatory surgical centers will receive an additional payment of up to $261.38 — beyond what they might already get for a procedure — when they bill with the unique C-code for iovera°, C98091
- The NOPAIN Act is valid for procedures through December 31, 2027
C9809
Use the unique iovera° HCPCS Code2 C9809 for additional reimbursement from the NOPAIN Act
Why this matters
- For Medicare recipients, this makes non-opioid pain options like iovera° more accessible
- For providers/hospitals, this reduces the financial disincentive to use non-opioid therapies, and encourages adoption of safer, opioid-sparing pain management options
- For public health, it aligns with efforts to reduce opioid prescriptions and combat opioid addiction risk by offering viable, reimbursed alternatives
Tips for successful
implementation
- Educate relevant stakeholders on the importance of accurate documentation to support billing and coding for iovera° and C9809
- Make sure the code is implemented into your chargemaster
- Track claims submissions and key outcomes to monitor reimbursement and impact of implementation
Rebill up to one year past
date of service
Medicare allows you to update claims within one year of the date of service. That means if your system has not yet operationalized NOPAIN Act reimbursement, you may still be able to collect payment for past iovera° treatments.
- 1. CMS Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2026, https://public-inspection.federalregister.gov/2025-20907.pdf
- 2. Centers for Medicare & Medicaid Services. (2025, December 8). HCPCS Quarterly Update. CMS. https://www.cms.gov/medicare/coding/hcpcsreleasecodesets/hcpcs-quarterly-update