Disclaimer: This WISeR Navigator is a proof-of-concept tool. Verify all prior authorization requirements and documentation against the latest CMS guidance and MAC publications before relying on the results.
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Check Medicare prior authorization status and documentation for WISeR pilot services.
Disclaimer: This WISeR Navigator is a proof-of-concept tool. Verify all prior authorization requirements and documentation against the latest CMS guidance and MAC publications before relying on the results.
Loading WISeR service data…
The Wasteful and Inappropriate Services Reduction (WISeR) model is a six-year CMS pilot launching January 1, 2026. It tests technology-enabled prior authorization to reduce fraud, waste, and abuse in Medicare fee-for-service while maintaining beneficiary access to clinically appropriate care.
WISeR runs for two consecutive agreement periods (three years each), spanning January 1, 2026 through December 31, 2031, with CMS evaluating performance before any broader expansion.
The pilot targets procedures with documented risks of overuse or clinical appropriateness concerns. WISeR focuses on prior authorization and pre-payment review for: