Are Epidural Injections​ Covered by Medicare?

Health Line

18 hours ago

Medicare should cover epidural steroid injections to relieve spinal pain caused by certain conditions lasting at least 4 weeks despite other treatment.
An epidural steroid injection is a noninvasive way that can help ease pain. A doctor injects steroids into the epidural space, which is the space around the spinal cord.
These injections help reduce inflammation caused by various spinal problems. Read on about Medicare coverage for epidural steroid injections to relieve pain.
When does Medicare cover epidural injections?
Original Medicare is comprised of Part A and Part B. Part A may cover epidural steroid injections when you're hospitalized, while Part B may cover these as an outpatient procedure. If you're enrolled in Medicare Advantage (Part C), you should receive the same coverage.
You should receive coverage if you're:
diagnosed with certain conditions like disc herniation, acute shingles pain, or post-laminectomy syndrome
experience pain that significantly affects your daily life
are dealing with pain for over 4 weeks despite trying other treatments
have had medical imaging, such as CT or ultrasound, showing a qualifying health issue causing the pain
Medicare won't approve injections without a clear cause for the pain, or if you also have an infection, spinal compression, are at high risk for cancer, or have a suspected cancer diagnosis. To get coverage, make sure that the healthcare professional administering your injections is qualified to do so, accredited, and accepts Medicare.
How do epidural steroid injections work?
An epidural steroid injection is a nonsurgical way to relieve pain, especially lower back pain radiating to the lower body or neck pain extending to the arms. A doctor injects a steroid into the epidural space to reduce inflammation and pain. This treatment is useful for conditions like spinal stenosis, radiculitis, sciatica, and herniated discs.
These injections may be cervical or lumbar. Cervical injections may be administered in two ways: Interlaminar, injecting between two vertebrae for broader coverage, or transforaminal, targeting a specific nerve root on the spine's side, often called a 'nerve block.' A single-level nerve block targets pain at a specific spinal level, while two-level or multilevel blocks address discomfort at multiple levels.
The number of injections Medicare will cover for your treatment depends on the type you get. Some may be approved for up to two levels per region and bilaterally if necessary, while others could be approved for just one level. If the first injections give you at least 50% pain relief for 3 months or more, you might receive approval for more.
How much do epidural injections cost through Medicare?
The cost of epidural steroid injections can vary depending on whether you have insurance, the type of injection you need, and the number of injections required.
For instance, a 2019 study evaluated medical costs for around 14,000 individuals with lumbar spinal fusion who received these injections and found that, on average, people spent about $1,060.67.
If you're covered by Part B, you'll need to meet a $257 deductible in 2025 before your coverage kicks in. Afterward, Part B will cover 80% of your costs. There's also a monthly premium, starting at $185, which varies depending on your income.
Under Part A, most people don't pay a premium, but you do need to meet a $1,676 deductible. After meeting this amount, Part A will cover all your hospital treatment costs for the first 60 days. Afterward, you'll start to share the daily cost each day until day 101, when you'll be responsible for the entire daily cost.
If you're enrolled in a Part C plan, it is managed by a private insurer and comes with its own premium, deductible, and coinsurance. The Centers for Medicare & Medicaid Services (CMS) reports that the average monthly premium for Part C plans is about $17 in 2025.
Keep in mind, you'll still need to pay the Part B premium to stay enrolled in a Part C plan, though some Part C plans might cover this cost for you.
Does Medicare cover epidurals during childbirth?
Epidural anesthesia, which is often used during childbirth, is different from steroid epidurals for spinal pain. Generally, receiving epidural anesthesia for childbirth while being covered by Medicare is uncommon, as most people become eligible for Medicare at age 65.
But you might qualify earlier because of a disability. If you become pregnant, Medicare Part A should generally cover anesthesia that is medically necessary during your hospital stay for delivery. This may include epidural anesthesia.
Takeaway
An epidural steroid injection can help relieve pain and inflammation from spinal issues. If you're experiencing severe pain that persists for more than 4 weeks and your pain is caused by specific conditions, Medicare may cover this treatment.
If you need the procedure in a hospital, Medicare Part A could cover it, while Part B could cover it when done as an outpatient procedure.
If you have Medicare Advantage (Part C), you'll get similar coverage.
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