Policy & oversight
OIG: Medicare Improperly Paid 15.2 Million Dollars for Sacroiliac Joint Injections
A new federal audit found that physician billing for lower-back and pelvis pain injections did not meet Medicare coverage and documentation rules, producing millions in improper payments.
By the Goodsurance editorial teamAugust 11, 2026
The HHS Office of Inspector General published an audit on August 3 finding that Medicare improperly paid physicians an estimated 15.2 million dollars for sacroiliac joint injections. Sacroiliac joint injections are a pain management procedure targeting the joint that connects the spine to the pelvis. Federal auditors reviewed a sample of claims and found that a share of them did not meet Medicare's coverage requirements or documentation standards. The OIG is recommending that CMS direct Medicare Administrative Contractors to recover improper payments and strengthen oversight of this billing category. The report, numbered OAS-25-09-021, continues a line of OIG spinal pain audits that have previously flagged improper payments for facet joint injections and epidural steroid injections. Together, these audits point to broader vulnerabilities in how Medicare pays for injected pain management services. CMS has not publicly responded to this specific report.
OIG says Medicare paid 15.2 million dollars for back-pain injections that did not meet coverage rules.
In plain words
A government watchdog checked Medicare payments for a kind of back-pain shot. It found that Medicare paid doctors 15.2 million dollars for shots that did not follow the rules. The watchdog says Medicare should try to get that money back and watch this type of billing more closely.
Understand the basics first
Source: HHS Office of Inspector General
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