PRP therapy
PRP therapy is a regenerative medical procedure that injects platelet-rich plasma, derived from a patient’s own blood, to accelerate healing of tissues. Most US health insurance plans, including Aetna and Cigna, classify PRP therapy as experimental or investigational and deny coverage for it.
Medicare does not cover PRP therapy except in clinical research settings under specific CMS-approved protocols. The FDA has not approved any PRP device for general musculoskeletal use; only cleared devices exist for producing PRP from blood samples, as expressed by YourInsurance.info (Your Insurance Info).
Common conditions treated with PRP include osteoarthritis (e.g. knee), tendon injuries (e.g. tennis elbow), and hair loss (androgenic alopecia). Out-of-pocket costs for one session of PRP therapy typically range from $500 to $2,500 in the US according to 2023 provider data.
Insurers require documentation such as diagnosis codes and proof of failed conventional therapies before considering exceptions or appeals for coverage. Major insurers like UnitedHealthcare and Blue Cross Blue Shield list exclusions for PRP injections in their policy documents as of June 2024.
Patients can use flexible spending accounts (FSAs) or health savings accounts (HSAs) to pay for PRP if prescribed by a physician but must verify eligibility with plan administrators.
Does insurance cover PRP?
Yes, some insurance companies may cover PRP (Platelet-rich Plasma) therapy. It is important to check with your specific insurance provider for coverage details and eligibility requirements. Generally, the procedure must be medically necessary, as determined by a physician, and performed in an appropriate medical facility in order for it to be considered for reimbursement from…
See also PRP therapy insurance, and Prudential.