Pick the service
Confirm Original Medicare and the state of service, then choose the WISeR service and clinical pathway.
Free for Original Medicare providers
Free Medicare WISeR documentation check
Paste a clinical note for automatic redaction. See which documentation elements reviewers expect for a Wasteful and Inappropriate Service Reduction (WISeR) service, what is already there and what is missing. No login.
Applies to Original Medicare in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington.
How it works
Paste the note
Remove direct identifiers when possible. Work-email verification and an acknowledgment/authority attestation are required before processing.
Close the gaps
See evidence found, missing elements, pitfalls and suggested documentation you can adapt.
Supported services
13 services in the current WISeR scope01Knee arthroscopic lavage and debridementView documentation guide02Induced lesions of nerve tractsView documentation guide03Vagus nerve stimulationView documentation guide04Phrenic nerve stimulationView documentation guide05Electrical nerve stimulatorsView documentation guide06Incontinence control devicesView documentation guide07Sacral nerve stimulationView documentation guide08Diagnosis and treatment of impotenceView documentation guide09Percutaneous vertebral augmentationView documentation guide10Epidural steroid injectionsView documentation guide11Cervical fusionView documentation guide12Hypoglossal nerve stimulationView documentation guide13Skin substitutes for chronic lower-extremity woundsView documentation guide
Criteria provenance
What sources does the WISeR check use?
Criteria bundle 7.0.1 is based on the CMS WISeR Provider and Supplier Operational Guide v7.0, effective . The cited CMS sources were last reviewed .
Effective National Coverage Determinations, Local Coverage Determinations and related Medicare Coverage Database articles control when they are newer or more specific than the operational guide. This educational check identifies documentation gaps; it does not make a coverage or prior-authorization decision.
Questions
What is WISeR?
Wasteful and Inappropriate Service Reduction is a CMS Innovation Center model for selected Original Medicare services in six states. Review requirements vary by service and clinical pathway.
When did the WISeR model start?
The six-year model began January 1, 2026 and runs through December 31, 2031. WISeR participants and Medicare Administrative Contractors began accepting prior authorization requests January 5, 2026 for services furnished on or after January 15, 2026.
Which patients does it apply to?
The model applies to Original Medicare beneficiaries receiving a listed service in Arizona, New Jersey, Ohio, Oklahoma, Texas or Washington. It does not apply to Medicare Advantage.
Which WISeR participant and Medicare contractor handles each state?
Arizona is assigned to Zyter Inc. with JF Noridian; New Jersey to Genzeon Corporation with JL Novitas; Ohio to Innovaccer Inc. with J15 CGS; Oklahoma to Humata Health, Inc. with JH Novitas; Texas to Cohere Health, Inc. with JH Novitas; and Washington to Virtix Health LLC with JF Noridian.
How long does a WISeR prior authorization decision take?
CMS says WISeR participants typically issue a determination within 3 calendar days after receiving an initial or resubmitted request. An expedited request is processed within 2 calendar days when a delay could seriously jeopardize the beneficiary’s life, health or ability to regain maximum function and the participant confirms that risk.
How long do providers have to answer a pre-payment documentation request?
If a claim enters pre-payment medical review, the billing provider or supplier has 45 calendar days from the documentation request to respond. After receiving all requested records, the WISeR participant issues its medical-necessity determination to the Medicare Administrative Contractor within 3 calendar days.
Does every code associated with a WISeR service require prior authorization?
No. Appendix A of the CMS guide identifies the primary CPT or HCPCS codes, while Appendix B can limit scope by diagnosis. Place of service, state and effective-date rules also matter. Appendix C associated codes do not independently undergo WISeR prior authorization, and codes covered by another CMS prior authorization program remain in that program.
Which WISeR services are delayed?
CMS delayed Deep Brain Stimulation and Percutaneous Image-Guided Lumbar Decompression for Spinal Stenosis. They are not currently subject to WISeR prior authorization or pre-payment review and may be reevaluated for a future performance year.
What does this check do?
It compares note text with the documentation elements for the selected WISeR service and identifies what is present, partial or missing. It does not predict approval.
Do you store my note?
Raw note text is never stored. The automatically redacted note and structured result are KMS-encrypted and scheduled to expire 30 days after submission. No note text is sent to logs, email, CRM, queues or analytics.
Is this medical, legal or coding advice?
No. Coverage decisions are made by CMS and its contractors. Use the output to improve documentation, not to decide whether a service is clinically appropriate.