Key efforts by the ASSFN were critical to securing Medicare coverage for focused ultrasound thalamotomy for tremor (MRgFUS thalamotomy) for tremor across all 50 states. While MRgFUS thalamotomy is widely recognized by stereotactic and functional neurosurgeons as a novel and effective treatment for essential tremor, the road to ensuring reimbursement for the procedure was not simple. Despite FDA approval as well as positive local coverage determination (LCD) by 5 of 7 regional Medicare Administrative Contractors (MACs), not all MACs felt the data and results were compelling enough to cover MRgFUS thalamotomy. The ASSFN, in collaboration with the Washington Committee, rapidly engaged the director, who expressed that a society guideline or position statement could help move the needle and drive a favorable coverage decision. The ASSFN immediately mobilized and wrote an official position statement which was published in Neurosurgery and used as a basis for coverage determination. As a result, as of July 12, 2020, MRgFUS thalamotomy for essential tremor will be covered across all 50 states by Medicare.