To address a need for national guidance on pain management practices during the COVID-19 pandemic, a panel including pain management experts from the military, Veterans Health Administration, and academia was convened. The proposed framework includes guidance for pain practitioners and institutions to balance risk mitigation for both providers and patients, staffing plans to prevent or minimize exposure of staff and patients, use of telehealth for pain management, conservation of resources, and access to pain management services. Any pain management plan must consider many facets including patients’ clinical circumstances and providers’ wellbeing.