EXCLUSIVE: AMA neurostimulator coding review panel membership undisclosed, raising questions of potential conflicts

A quiet but consequential policy process inside the American Medical Association is drawing increasing attention from industry observers and Hill staff as questions emerge about transparency and financial ties tied to decisions that shape how medical devices are paid for across the United States.

At the center of the issue is the AMA’s control over the Current Procedural Terminology code set, which determines how physicians bill for procedures and is used by the Centers for Medicare and Medicaid Services as well as private insurers to set reimbursement. In practice, CPT codes often decide whether a treatment is financially viable for doctors to offer at all.

In the fast-growing field of neuromodulation, those decisions carry particular weight. Devices used for peripheral nerve stimulation are competing in a rapidly expanding market tied to chronic pain treatment, with the U.S. PNS segment projected to grow at nearly 19 percent annually over the next five years. Whether a device is classified as “integrated,” combining components into a single unit, or non-integrated can meaningfully affect how procedures are coded and reimbursed, a distinction examined in recent consensus guidelines published in the Journal of Pain Research by the American Society of Pain and Neuroscience.

In October 2025, the AMA announced that the chair of its CPT Editorial Panel had approved a multi-specialty workgroup to address “the growing concerns of neurostimulator coding.” According to the AMA’s own description, the group’s charge is to “evaluate and clarify the CPT coding structure for neurostimulator systems by addressing stakeholder concerns and potential gaps in current guidance.”

The timing has drawn attention. Days before the AMA’s announcement, Boston Scientific disclosed a definitive agreement to acquire Nalu Medical, a peripheral nerve stimulation company, for an upfront cash payment of approximately $533 million. Boston Scientific completed the acquisition in January 2026, consolidating two of the companies whose products are most directly affected by the coding decisions now under review. The underlying neurostimulator codes have been in use since the CPT 2025 set took effect on January 1, 2025, without reported confusion among Medicare or private payers.

In response to questions from the Reporter, AMA spokesman R.J. Mills pointed to two publicly available resources: the full roster of CPT Editorial Panel members and the CPT Conflicts of Interest Policy governing Panel members. The policy requires Panel members and presenters to disclose individual and corporate financial interests, addresses recusal expectations, and is a condition of participation.

Panel members must annually sign agreements affirming compliance with the COI policy, the confidentiality agreement, and the panel’s lobbying statement, according to the AMA’s nomination criteria.

The AMA did not, however, identify the specific physicians serving on the neurostimulator workgroup, which is distinct from the Editorial Panel itself, or respond to a follow-up question asking for the membership of that specific workgroup.

Federal Open Payments data shows that physicians active in the neuromodulation field have extensive financial relationships with companies whose products are directly affected by these coding decisions, including Boston Scientific and, previously, Nalu Medical. Disclosures in peer-reviewed research reflect similar patterns. The ASPN consensus guidelines note that all participating authors disclosed financial conflicts of interest and were asked to recuse themselves on issues involving competing relationships.

Industry relationships between physicians and device manufacturers are common and, in the research context, routinely disclosed. The unresolved question is how those relationships are handled when the same physicians may be in a position to influence how those devices are classified for payment inside the AMA’s working groups.

The CPT Editorial Panel’s process is largely closed to the public. Participants in code set review, panel meetings, and related proceedings are required to sign confidentiality agreements that restrict disclosure of code change applications, communications among panel members and advisors, and the names and affiliations of those who testify. Open Editorial Panel meetings do allow stakeholder participation, and a hybrid stakeholder session was held alongside the February 2026 Panel meeting.

For policymakers and patients alike, the questions that matter are practical ones. Coding decisions inside the AMA shape what doctors can offer and what patients are able to receive. As the neurostimulator workgroup proceeds, the Reporter will continue tracking how it discloses its membership, applies its conflict-of-interest standards, and arrives at recommendations that ripple through Medicare and private insurance reimbursement.