Hyaluronic Acid Intra-articular Products

Covered: FDA‑approved intra‑articular hyaluronic acid injections for knee osteoarthritis (not covered for non‑FDA joints/indications), with adherence to product‑specific dosing. Key requirements: radiologic confirmation of knee OA, prior failure of conservative therapy and analgesics plus trials of at least TWO of these modalities—(1) a course of physical therapy, (2) two pharmacologic therapies from NSAID/acetaminophen/tramadol/duloxetine (two NSAIDs count as one), and (3) at least two intra‑articular corticosteroid injections—administered by or under a rheumatologist/orthopedic surgeon/physiatrist; initial/renewal approvals are for 6 months, reauthorization requires ≥6 months since last HA injection and documented prior treatment response.

"Indicated for the treatment of pain in osteoarthritis of the knee in individuals who have failed to respond adequately to conservative non-pharmacologic therapy and analgesics (e."