New Medicare Changes in 2026: Prior Approval Required for These 17 Services
- Seth Clayton
- Aug 27
- 2 min read
Updated: Oct 8

Beginning January 1, 2026, certain medical procedures under Traditional Medicareย will require prior authorizationย in six U.S. states. This means your healthcare provider must obtain approval from Medicare beforeย performing specific servicesโotherwise, coverage may be denied.
This update also affects individuals with Medigap plansย such as Plan Gย or Plan N, if they're using Traditional Medicare coverage.
The change is part of a pilot initiative called WISeRย (Wasteful and Inappropriate Services Reduction), which is designed to curb medical overuse and detect potential fraud.
๐ Which States Will See These Medicare Changes in 2026?
Residents in the following six states will be included in the initial rollout:
Arizona
New Jersey
Ohio
Oklahoma
Texas
Washington
๐ Which Medical Services Are Affected?
A total of 17 types of proceduresย will now need prior approval. These services are often flagged for being overused or not always medically necessary. Here's whatโs on the list:
Electrical Nerve Stimulators
Sacral Nerve Stimulation for Urinary Incontinence
Phrenic Nerve Stimulator
Deep Brain Stimulation for Essential Tremor and Parkinsonโs Disease
Vagus Nerve Stimulation
Induced Lesions of Nerve Tracts
Epidural Steroid Injections for Pain Management
Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture
Cervical Fusion
Arthroscopic Lavage and Arthroscopic Debridement for Osteoarthritic Knee
Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea
Incontinence Control Devices
Diagnosis and Treatment of Impotence
Percutaneous Image-Guided Lumbar Decompression for Spinal Stenosis
Skin and Tissue Substitutes (including bioengineered skin and CTP wound applications)
For these treatments, physicians will be required to submit documentation beforeย the service is performed. If approval isnโt granted, coverage could be deniedโleaving patients to pay out of pocket. Here is the official Federal Registry document.
๐ก Why Is This Happening?
The main goals of this policy include:
Preventing unnecessary or high-risk procedures
Lowering healthcare costs by avoiding waste
Combatting Medicare fraud
Using advanced tools, like AI, to streamline request reviews (with final decisions still made by human reviewers)
โ ๏ธ What It Could Mean for You
Doctors might need extra timeย to get necessary approvals
Some treatments could be delayedย due to administrative steps
Patients may face more paperworkย and longer wait times
The WISeR program is scheduled to run through 2031. If proven effective, it may be expanded to more states or additional services.
โ Key Takeaways: Pros & Cons
Benefits:
Helps eliminate fraudulent or unnecessary care
Encourages more appropriate and cost-effective treatment
May improve patient safety by requiring thorough review
Drawbacks:
Potential for delays in receiving needed treatments
More administrative work for healthcare providers
Could cause frustration for both patients and doctors
If you live in one of the six pilot states, now is a good time to talk with your healthcare provider about how this change might impact your future care. Planning ahead can help you avoid surprises once these new requirements go into effect.