From the Boulder Medical Center Orthopedics Team
Hyaluronic Acid Injections & Medicare: What Patients Need to Know for 2024
To our orthopedic patients:
This correspondence concerns a prior letter you received involving Medicare and the new parameters imposed around hyaluronic acid injections (Gelsyn, Euflexxa, Supartz, etc). Hopefully, this will alleviate some of the confusion and add clarification to these “rules.”
Primarily, in regard to the X-ray requirement, Medicare requires a set of X-rays to be performed every 18 months. If you have not had these done in that time frame, our office will contact you to schedule them.
They do not need to be done immediately, simply before or on the day of the first injection of your next injection series. Some of you have had these performed within this allotted time; however, if not, we will keep track of this for you.
Next, for the last six months, our office has documented conservative measures that have been tried and failed for each patient. This includes but is not limited to, physical therapy, cortisone injections, weight loss, orthotics, and medications, such as ibuprofen and naproxen. We had a sneaking suspicion this was coming, so we have also been covering this requirement. In addition, we have been documenting improvements noted during and after the injection series.
Again, you do not need to have actively failed these things; we simply must put this into our documentation. Lastly, most of you know that it is necessary for six months and one day to have passed between the last injection in a series and the first injection of the next series. This has always been the case for most brands. Supartz allowed a 4-month interval, but unfortunately, that will not be allowed moving forward.
If your symptoms recur between series, we can consider other treatment options, such as cortisone, toradol, or platelet-rich plasma injections. We will be happy to discuss these options with you if needed.
The above requirements took effect in 2024. We are doing everything we can to ensure that these new “rules” are met so that you can continue to receive your injections without a delay in care. Please feel free to reach out to the Orthopedic office with any questions. Sorry for any confusion or concern the initial letter may have caused.