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For Medicare Advantage Part B: PHONE: 18665030857 FAX: 18442687263MEDICARE FORM Viscosupplementation Injectable Medication Precertification RequestFor other lines of business: Please use other form.

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Related content

Hyaluronic Acid/ Viscosupplementation (Re-Review)...
Oct 14, 2013 — Meta-analyses of RCTs of viscosupplementation versus control (typically...
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Procedures, programs and drugs that require...
May 1, 2020 — Precertification for all members with HMO-based,. Aetna Medicare Advantage...
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The cost for intra-articular solution (16 mg/2 mL) is around $417 for a supply of 2 milliliters, depending on the pharmacy you visit.

Yes, Aetna's CPB for this states that ultrasound-guided injection is not covered since they consider it experimental.

Medicare will cover knee injections once every six months if they are medically necessary. The injections are covered under Medicare Part B and subject to the annual Part B deductible. X-rays are required prior to Medicare approval.

If medically necessary, Medicare will reimburse the cost of hyaluronic acid injections for osteoarthritis of the knee. However, it does not cover other forms of osteoarthritis, such as for the hip or shoulder.

Viscosupplementation will not be covered: When the diagnosis is anything other than osteoarthritis. For intra-articular injection in joints other than the knee. As the initial treatment of osteoarthritis of the knee.

Often utilized to stop pain by Alex J. Nelson, MD, some may know this procedure to be called hyaluronan injections or hyaluronic acid injections. Brand names of viscosupplementation solutions include Hylagan, , , , and – all of which we use at Peak Health and Wellness.

Viscosupplementation of joints other than the knee(s) will be considered not reasonable and necessary and will not be subject to coverage. Imaging procedures performed routinely for the purpose of visualization of the knee to provide guidance for needle placement will not be covered.

On MDsave, the cost of a Gel One Injection ranges from $1463 to $3159. Those on high deductible health plans or without insurance can shop, compare prices and save.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232