This is a Medicare Part B covered medication, but all the doctors I contacted told me that I have to purchase it myself & then bring it to them. There would be no reimbursement for my costs ... $1,6000. One doctor's office told me to order it through a Canadian pharmacy for about $400. Medicare can't tell me why the doctors are doing this only that it is not the way it's supposed to work.
That sounds strange. Drugs covered under Medicare Part B are usually supplied by the Dr office. Best thing for you to do is to get on the phone with your insurance carrier. Call the member services number on your card and ask them. You may even try the CMS website if you have straight Medicare only. From what I know this should be covered under Medicare B because it is not something that you can give yourself. It can olny be administered by a Dr so therefore should be covered under Part B. If you have spoken to both the Dr office and Medicare then you need to have the Dr office talk to medicare in your presence. Here is a link to what I found on the CMS website. Somehow the Drs offices are misinformed. Here is the link:
What applies to you is under the injectable drugs. Good Luck. nothing like being stuck in the middle between two that keep contradicting each other! Print this list and take it to the Dr office with you!
All Hyaluronic acid preparations have been approved by the FDA as a DEVICE for the treatment of pain in osteoarthritis of the knee in patients who have not responded to exercise, physical therapy and non-prescription analgesics.
The Centers for Medicare & Medicaid Services (CMS) assigned a reimbursement HCPCS ("J") Code to hyaluronan injectables used to improve mobility and treat knee pain caused by osteoarthritis.The HCPCS J Code, J7319, took effect in January 2007 and covered all hyaluronic acids. Previously, hyaluronan injectables were assigned a miscellaneous code that required manual billing and caused challenges and delays in processing claims.
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