Effective October 1, prior authorization (PA) criteria will be updated for all non-preferred hyaluronic acid products for Medicare members to ensure they’re used in accordance with guidelines from the Centers for Medicare & Medicaid Services (CMS). Find updated PA requirements on the Medicare Local Coverage Determination (LCD) webpage (Jurisdiction 8) or by using the Medicare Coverage Database.
The following preferred hyaluronic acid products will remain covered with no PA requirements:
- Euflexxa
- Durolane®
- Gelsyn-3
- Supartz FX
What do you need to do?
We recommend reviewing PA criteria before submitting a prescription for a non-preferred hyaluronic acid product or prescribing a preferred hyaluronic acid product.