Are clinicians required to ask patients about pain during every visit?

This resource is part of the AMA's Debunking Regulatory Myths series, supporting AMA's practice transformation efforts to provide physicians and their care teams with resources to reduce guesswork and administrative burdens.

There is no federal or state regulation that recommends or requires inquiries about pain at every visit.

In their 2001 original pain standards, the Joint Commission had a requirement that each patient receive a pain assessment. This requirement was eliminated in 2009 from all programs except Behavioral Health Care Accreditation. The current version of the standard for hospitals and programs other than behavioral health states that, “The hospital assesses and manages the patient's pain” and recognizes that approaches to assessing pain differs depending on the patient^1,2 This standard allows organizations to set their own policies regarding which patients should have pain assessed based on the population served and the services delivered. Joint Commission surveyors determine whether such policies have been established, and whether there is evidence that the organization’s own policies are followed.

The AMA is not aware of any federal or state regulations that recommend or require inquiries about pain at every visit, although it may be wise to contact your state medical association to determine whether there are nuances in state law or regulation that may be relevant.

De-implementing requirements for pain assessments at every patient visit can save physicians time and strengthen the physician-patient relationship—as well as professional satisfaction—by prioritizing the aspects of the patient’s health most important to address at each opportunity.

• Joint Commission Accreditation Standard for Pain Assessment H-220.928
• Pain as the Fifth Vital Sign D-450.956

• The Joint Commission R3 Report on Pain Assessment and Management. Accessed November 2024.
• AMA STEPS Forward® Success Story: Developing a Standardized Approach for Patients with Chronic Pain Who Are Establishing Care. Accessed November 2024.

1. The Joint Commission. R3 Report Issue 11: Pain Assessment and Management Standards for Hospitals.; 2017. Accessed November 20, 2024. https://www.jointcommission.org/-/media/tjc/documents/resources/pain-management/r3_report_issue_11_pain_assessment_2_11_19_rev.pdf
2. The Joint Commission. Pain Assessment and Management – Understanding the Requirements. The Joint Commission. September 13, 2018. Accessed November 20, 2024. https://www.jointcommission.orghttps://www.jointcommission.org/standards/standard-faqs/ambulatory/provision-of-care-treatment-and-services-pc/000002212/

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Disclaimer: The AMA's Debunking Regulatory Myths (DRM) series is intended to convey general information only, based on guidance issued by applicable regulatory agencies, and not to provide legal advice or opinions. The contents within DRM should not be construed as, and should not be relied upon for, legal advice in any particular circumstance or fact situation. An attorney should be contacted for advice on specific legal issues. Additionally, all applicable laws and accreditation standards should be considered when applying information to your own practice.