CommercialCoverageHigh impact
State and School Employees' Health Insurance Plan - Intra-articular Hyaluronan Injections for Osteoarthritis
Blue Cross & Blue Shield of Mississippi·MS · Orthopedics, Rheumatology, Sports Medicine +1 more·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Mississippi State and School Employees' Health Insurance Plan significantly restricted hyaluronic acid injections for knee osteoarthritis, now covering only Durolane and Euflexxa while excluding 13 other products including Synvisc, Hyalgan, and Monovisc. Multiple HCPCS codes moved from covered to non-covered status effective January 1, 2025.
Action Required
By January 1, 2025: Billing team must update system to only allow J7318 (Durolane) and J7323 (Euflexxa) for knee hyaluronic acid injections. Block billing for J7320, J7321, J7322, J7324, J7325, J7326, J7327, J7328, J7329, J7331, and J7332 as these are no longer covered. Update encounter forms to specify only covered products. Providers must ensure patients meet criteria of insufficient pain relief from conservative therapy before injection. Claims for non-covered products will be denied.