December 22, 2025
We are pleased to welcome you to the CMS/CMMI Wasteful and Inappropriate Service Reduction (WISeR) Model. This prior authorization program is launching in Washington state on January 1, 2026, for select procedures performed on/after January 15, 2026. Procedures included in this model include:
- Percutaneous Image-Guided Lumbar Decompression for Spinal Stenosis (NCD 150.13);
- Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee (NCD 150.9);
- Induced Lesions of Nerve Tracts (NCD 160.1);
- Vagus Nerve Stimulation (NCD 160.18);
- Phrenic Nerve Stimulator (NCD 160.19);
- Electrical Nerve Stimulators (NCD 160.7);
- Incontinence Control Devices (NCD 230.10);
- Sacral Nerve Stimulation for Urinary Incontinence (NCD 230.18);
- Diagnosis and Treatment of Impotence (NCD 230.4);
- Percutaneous Vertebral Augmentation for Vertebral Compression Fracture (LCD L34106);
- Epidural Steroid Injections for Pain Management (LCD L39240);
- Cervical Fusion (LCD L39758);
- Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea (LCD L38310);
- Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds and Wound Application of CTPs, Lower Extremities (LCD 39764)
Providers and suppliers have two WISeR Model pathways:
1. Prior Authorization:
- Submit a prior authorization request to receive a determination prior to administering WISeR select items and services.
- May be submitted via electronic portal, mail or fax. A determination will be issued within 3 days of receiving the request.
2. Pre-Payment Medical Review:
- Furnish WISeR select items and services immediately and wait for the determination through pre-payment review.
- An ADR (additional documentation request) will be sent to the Provider, which will have 45-days to return before the medical review may commence. A determination will be issued within 3 days of receiving all necessary documentation.
In order to submit and track prior authorization requests electronically you will need to register for the Virtix Health WISeR Provider Portal.
- You will receive an email from donotreply.wisersupport@virtixhealth.com in the next 48 hours
- This email will have your USERID/Temporary Password/URL and instructions.
- The password code will be valid for 7 days.
- If you do not receive the email or are unable to complete registration within 7 days of receipt, please reach out to wiser.support@virtixhealth.com for assistance.
- Please download the Microsoft Authenticator App on your iPhone/Android device. This is needed to complete onboarding.
To save time, electronic submission will allow you to track the status of your request and receive a quicker response. However, if you prefer, prior authorization requests can also be submitted via fax at 972-823-9415 or mailed to:
Virtix Health
6509 Windcrest Dr Ste 165
Plano TX 75024
When submitting a request please provide a request document https://virtixhealth.com/wiser/wiser-intake-form-download/ and complete medical record documentation to support the request.
If you have questions or need assistance please do not hesitate to contact us via email at wiser.support@virtixhealth.com or call us Monday thru Friday between the hours of 8am-6pm PST at 833-943-2209.
We look forward to working with you.
Sincerely,
Virtix Health
