Procedural pain management

Accreditation is required for community-based physician offices, practices and clinics wishing to perform procedural pain management. This includes caudal and interlaminar lumbar epidural procedures, advanced I procedures and advanced II procedures.


Accreditation standards for community-based PPM offices, practices and clinics have been approved by the Non-Hospital Medical and Surgical Facilities Accreditation Program (NHMSFAP) Committee. The process for developing these standards included convening an advisory panel of subject-matter experts in pain medicine, anesthesiology (including family practice anesthesia), interventional radiology, and physical medicine and rehabilitation, as well as two rounds of public consultation.

The PPM accreditation standards address:

  • physician credentialing and privileging
  • procedures that require an accredited facility or should only be done in a hospital
  • imaging requirements (ultrasound, fluoroscopy, CT)
  • infection, prevention and control requirements
  • patient safety and quality care requirements

Credentialing and privileging for PPM

Physicians wishing to continue performing caudal and interlaminar lumbar epidurals, and advanced I and advanced II procedures in the community setting must meet the requirements outlined in the BC Medical Quality Initiative (BCMQI) privileging dictionary for their specialty for training and current experience. Physicians who do not meet the requirements as outlined in their respective dictionary may no longer perform these procedures in non-health authority community settings.

All physicians meeting the criteria to perform the procedures in Appendix A in the community setting were required to complete an application package and undergo a review of PPM scope of practice. This was completed in March 2021.

Application is required for performing PPM procedures in an accredited non-hospital or PPM facility

Physicians must complete an application package if they are looking to perform any Appendix A PPM procedures in:

  • an accredited non-hospital or
  • an accredited PPM facility, and
  • who have not completed a scope review

Apply for appointment to a medical/surgical facility

Guidelines for applying for appointment to a medical/surgical facility

Looking for more information about the process? See Credentialing and privileging for non-hospital facilities.


Accreditation of facilities wishing to perform procedural pain management will be implemented in a phased approach, starting with provisional accreditation.

Initially, provisional accreditation will be required to continue performing caudal and interlaminar lumbar epidural procedures, advanced I procedures, and advanced II procedures in community-based physician offices, practices and clinics. To be awarded provisional accreditation, these facilities must submit an application for provisional accreditation, complete a checklist confirming that they meet a subset of the PPM standards (minimum requirements) to ensure patient safety, and pay their annual fees. Facilities are not permitted to perform PPM until their application, checklist and annual fees are received.

Once awarded provisional accreditation, facilities will have until February 28, 2022 to conform with all PPM standards, including the applicable imaging modalities, and to prepare for an on-site accreditation assessment.  Scheduling of on-site accreditation assessments will begin in March 2022. Following their on-site assessment, facilities demonstrating conformance with all PPM standards will be awarded full accreditation.

Accreditation standards