CMS Expands Non-Opioid Payments, Boosting Key Post-Surgery Devices

ALPHARETTA, GA – February 03, 2026 – In a move that reinforces the federal government's commitment to fighting the opioid epidemic, the Centers for Medicare and Medicaid Services (CMS) has expanded reimbursement for non-opioid pain management technologies. The decision, part of the 2026 Medicare Hospital Outpatient Prospective Payment System (OPPS) Final Rule, ensures continued separate payment for two of Avanos Medical's infusion pump systems and adds a third device, the Game Ready cryo-pneumatic system, to the list of eligible products starting this year.

This update is a direct result of the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act, a landmark piece of legislation designed to remove financial barriers that have historically limited the use of effective but more costly opioid alternatives in outpatient surgical settings. By providing a separate payment pathway, the policy incentivizes hospitals and ambulatory surgery centers (ASCs) to adopt technologies that can reduce or eliminate the need for post-operative opioids, a critical step in preventing new cases of addiction.

A Policy Shift to Combat the Opioid Crisis

The NOPAIN Act, passed in late 2022, represents a fundamental shift in how Medicare addresses post-surgical pain. For years, the standard payment model bundled the cost of pain management into a single payment for a surgical procedure. This system inadvertently created a financial disincentive for providers to use innovative non-opioid drugs and devices, which are often more expensive upfront than generic opioids. Hospitals were forced to absorb the extra cost, making cheaper, addiction-risk opioids the default economic choice.

The NOPAIN Act dismantles this barrier by mandating separate payments for qualifying non-opioid treatments from January 1, 2025, through December 31, 2027. This ensures that when a hospital or ASC uses an approved device like an Avanos pump, they receive an additional payment specifically for that technology, on top of the payment for the surgery itself. This removes the financial penalty and allows clinical judgment, rather than cost alone, to guide pain management decisions.

Under the 2026 final rule, CMS reaffirmed the eligibility of the Avanos ON-Q* elastomeric infusion pump and the ambIT* electronic infusion pump, which first qualified in 2025. Critically, it expanded the list to include the Game Ready* GRPro 2.1 system, a device that uses targeted cold and compression therapy to reduce pain and swelling. All three devices have been validated by CMS based on clinical evidence showing their ability to replace or significantly reduce the need for opioids after surgery.

Reshaping the Market for Pain Management

The CMS decision solidifies Avanos Medical's position as a key player in the burgeoning non-opioid market. With three distinct technologies now eligible for separate reimbursement, the company is poised to capitalize on the growing demand for safer pain management solutions. The newly assigned payment limitations are substantial: $2,008.72 for both the ON-Q and ambIT infusion systems, and $1,997.16 for the Game Ready system, when deemed medically necessary.

"We applaud CMS for recognizing the value of ON‑Q and ambIT pumps and the Game Ready system under the NOPAIN Act," said Dave Pacitti, CEO of Avanos Medical, in a statement. "This decision reinforces CMS' commitment to expanding patient access to safe, effective, non‑opioid pain management options."

Avanos is not alone in this space. The NOPAIN Act has invigorated a competitive landscape that includes pharmaceutical options like Pacira Pharmaceuticals' long-acting anesthetic Exparel and Heron Therapeutics' Zynrelef, as well as other device-based solutions like peripheral nerve stimulators and cryoablation probes. The legislation has effectively created a new, more level playing field where companies can compete based on clinical efficacy and patient outcomes, rather than being sidelined by outdated payment structures.

For healthcare facilities, this translates into a wider array of financially viable options. Each of the qualifying Avanos devices now has a unique Healthcare Common Procedure Coding System (HCPCS) code, simplifying the billing process and ensuring facilities can confidently adopt these technologies without facing a financial shortfall.

From Policy to Patient: The Real-World Impact

Beyond the financial and market implications, the true impact of the NOPAIN Act is felt in the operating room and during a patient's recovery. For the millions of Americans who undergo outpatient surgery each year, this policy change could mean a dramatically different and safer experience.

Instead of leaving a hospital with a 30-day prescription for powerful opioids, a patient might now go home with a portable infusion pump like the ON-Q or ambIT. These devices deliver a continuous, targeted flow of local anesthetic directly to the surgical site, providing localized pain relief for several days without the systemic side effects of opioids, such as nausea, constipation, cognitive fog, and the profound risk of dependency.

Similarly, a patient recovering from orthopedic surgery might be prescribed the Game Ready system. This technology circulates ice water and intermittent pneumatic pressure through a body-part-specific wrap, actively reducing swelling and pain without pharmaceuticals. Clinical research has shown that such therapies not only reduce opioid consumption but can also contribute to a faster and more comfortable recovery, enabling patients to start physical therapy sooner and return to their daily lives more quickly.

This shift also provides significant benefits for healthcare providers. By reducing reliance on opioids, hospitals and ASCs can decrease the incidence of opioid-related adverse events, which are costly to manage and can lead to longer hospital stays. One university center, for instance, reported saving $34,000 in just six months by implementing the ambIT system. The separate reimbursement provided by the NOPAIN Act now makes the business case for adopting these superior clinical pathways even stronger.

The Future of Non-Opioid Reimbursement

While the NOPAIN Act is a monumental step forward, its provisions are currently set to expire at the end of 2027. This temporary nature has prompted patient advocates, medical societies, and industry leaders to begin lobbying for a more permanent solution.

The consensus among public health experts is that a three-year window is not enough to fully reverse decades of opioid-centric pain management. Advocacy groups like Voices for Non-Opioid Choices are already working to ensure the policy is extended, arguing that a long-term commitment is necessary to drive sustained change in clinical practice and continue fostering innovation.

Furthermore, legislative efforts are underway to expand upon the NOPAIN Act's success. The proposed Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act, for instance, seeks to address similar financial barriers within Medicare Part D, which covers prescription drugs. It aims to lower patient cost-sharing for non-opioid medications and remove administrative hurdles like prior authorization that can delay access to safer treatments.

The ongoing support for these policies signals a durable, bipartisan consensus: preventing addiction on the front end by providing better alternatives is far more effective and humane than dealing with its devastating consequences. The recent CMS rule is a clear affirmation of this strategy, ensuring that for the next few years, Medicare patients will have greater access to a recovery free from the shadow of opioid dependence.