Does Medicare Cover Synvisc Knee Injections for Joint Pain?

In this article...
  • Synvisc knee injections may improve osteoarthritis symptoms such as pain and stiffness. Review whether Medicare covers this treatment for chronic discomfort.

Synvisc injections can alleviate pain, stiffness and mobility issues caused by osteoarthritis of the knee. Medicare plans cover Synvisc when a physician determines the treatment is medically necessary.

When Does Medicare Cover Synvisc?

The Centers for Medicare and Medicaid Services report that Medicare plans cover these injections when a doctor documents their medical necessity to treat osteoarthritis. CMS requires members to meet these conditions for Synvisc coverage:

  • Pain and/or stiffness that affects the ability to do daily activities like sleeping, walking and standing
  • X-rays that show signs of knee osteoarthritis, such as cysts or narrowed joint space
  • Documentation of exclusion of other conditions that may cause knee pain
  • Documentation of at least 3 months of other types of treatment without success, such as exercise, over-the-counter pain medications, physical therapy, weight loss, aspiration and/or steroid injections

Medicare will cover another round of Synvisc injections after 6 months if symptoms recur. In this case, the healthcare provider must demonstrate that the patient was able to decrease the use of steroid injections or NSAIDS or had significantly reduced pain and improved function.

How Does Synvisc Work?

Hyaluronate is the active ingredient in this injectable medication. When injected once a week for 3 weeks, it lubricates the knee joint to reduce pain.

Does Synvisc Cause Side Effects?

After treatment with Synvisc, some patients experience mild discomfort, swelling, bruising or redness at the injection site. Following healthcare provider instructions, such as avoiding activity for 48 hours, can reduce the risk of side effects. People who have skin diseases or infections of the knee cannot receive this treatment.

Does Synvisc Come in a Generic Version?

Synvisc does not currently have an exact generic equivalent. However, doctors may prescribe a different injection with hyaluronate, such as Supartz, Orthovisc or Monovisc, or generic hyaluronic acid injections that work like Synvisc.

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