The federal NOPAIN Act (Non-Opioids Prevent Addiction in the Nation Act), which took effect Jan. 1, 2025, created a separate Medicare reimbursement pathway for qualifying non-opioid pain management therapies in ASCs and HOPDs.
For orthopedic providers, the legislation expands access to clinically established, evidence-based therapies—such as continuous cold therapy—that have historically represented an out-of-pocket expense for many patients.
DonJoy® IceMan® systems are the only single-patient continuous cold therapy systems currently eligible for separate Medicare reimbursement under the NOPAIN Act.
Continuous cold therapy has been used for decades to help reduce post-operative pain and swelling, support rehabilitation and recovery, and serves as an important component of a multimodal, opioid-sparing approach to pain management. As the orthopedic community continues to advance opioid stewardship efforts, non-opioid therapies are playing an increasingly vital role in helping patients recover safely and effectively after surgery.
As orthopedic procedures continue to migrate to ASCs and HOPDs, the NOPAIN Act gives providers a new opportunity to integrate cold therapy into routine care while supporting reimbursement, improving patient access, and enhancing the outpatient experience.
Continuous Cold Therapy: The Clinical Case
Continuous cold therapy has been a trusted component of orthopedic recovery for decades, helping reduce post-operative pain and swelling, supporting rehabilitation across a wide range of procedures.
Many outpatient orthopedic interventions involve a short but intense period of post-op pain, making continuous cold therapy a practical addition to recovery. By addressing acute inflammation and swelling, continuous cold therapy complements regional anesthesia, NSAIDs, acetaminophen, and other non-opioid treatments as another evidence-supported tool to reduce opioid exposure.
For patients recovering at home, consistency is critical. DonJoy® IceMan® systems deliver up to eight hours of continuous cold therapy, reducing the need to replace ice packs and making it easier for patients to stay ahead of pain during the early recovery period.
Peer-reviewed evidence has associated IceMan® with meaningful reductions in opioid consumption—including an average reduction of 53 morphine milligram equivalents (MME) during the first postoperative week—as well as earlier discontinuation of opioid use. Clinical data have also demonstrated lower pain scores early as post-operative day two.
Why It Matters for ASCs and HOPDs
Until recently, cost often limited patient access to continuous cold therapy. The NOPAIN Act helps remove that barrier, establishing a defined Medicare reimbursement pathway.
Eligible facilities bill qualifying IceMan® systems using HCPCS code C9810. The therapy may also be reimbursable under certain Medicare Advantage plans, subject to applicable plan requirements. Facilities can incorporate continuous cold therapy into standardized discharge and recovery protocols for a consistent patient experience.
Supporting Opioid Stewardship
Orthopedic providers play an important role in reducing unnecessary opioid exposure while delivering effective post-op pain management. Continuous cold therapy complements regional anesthesia, NSAIDs, acetaminophen, and other non-opioid interventions as part of a multi-pronged recovery strategy.
The NOPAIN Act now gives ASCs and HOPDs a defined Medicare reimbursement pathway to incorporate clinically validated continuous cold therapy into routine orthopedic care.
For providers, that’s more than a reimbursement opportunity—it’s an opportunity to translate clinical evidence into better recovery, lower opioid exposure, and better post-operative care.
The NOPAIN Act: Four Things to Know
NOPAIN Act Reimbursement
The federal NOPAIN Act created a separate Medicare reimbursement pathway for qualifying non-opioid pain management therapies, including continuous cold therapy. DonJoy® IceMan® systems are the only single-patient continuous cold therapy systems currently eligible for separate reimbursement.
Evidence-Backed Care
Backed by decades of clinical use, continuous cold therapy helps reduce post-operative pain and swelling, supports recovery, and plays an important role in multimodal, opioid-sparing pain management.
Value for ASCs and HOPDs
As more orthopedic procedures move to outpatient settings, reimbursement helps remove long-standing financial barriers to patient access while supporting standardized recovery pathways.
Supporting Opioid Stewardship
Orthopedic providers play an important role in reducing opioid exposure. Studies have shown that patients using IceMan® required fewer opioids and discontinued opioid use earlier than those receiving standard pain management protocols.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
