Does Medicare Cover PRP Injections? Costs

According to the Centers for Medicare & Medicaid Services (CMS), Medicare currently does not provide broad coverage for platelet-rich plasma (PRP) injections, except under clinical trials for chronic non-healing wounds.

What Are PRP Injections?

To understand Medicare’s coverage, let’s first look at what PRP therapy actually is.

Platelet-Rich Plasma (PRP) is a regenerative treatment that uses a patient’s own blood to promote healing. Doctors draw a small amount of blood, spin it in a centrifuge to concentrate the platelets, and inject it into the affected area.

Purpose: PRP is designed to boost tissue repair and reduce inflammation.
Common Uses: Osteoarthritis, rotator cuff tears, tendonitis, tennis elbow, knee pain, and even hair restoration.
Effectiveness: Some studies show positive results, but research is ongoing.

According to the American Academy of Orthopaedic Surgeons (AAOS), PRP shows promise in reducing pain and improving function in conditions like knee osteoarthritis, but clinical evidence remains mixed.

Does Medicare Cover PRP Injections?

Here’s the short answer: No, Medicare does not cover PRP injections for most conditions.

The Centers for Medicare & Medicaid Services (CMS) states that PRP is considered experimental and investigational for musculoskeletal and orthopedic conditions. Because it lacks strong long-term clinical evidence, Medicare excludes it from routine coverage.

Medicare may cover PRP therapy only for chronic non-healing diabetic, pressure, and venous wounds, and even then, it’s limited to patients enrolled in clinical trials.

So, if you’re hoping to use PRP for arthritis, joint pain, or sports injuries, Medicare won’t pick up the bill.

Why Doesn’t Medicare Cover PRP?

Medicare typically requires strong, consistent medical evidence before covering new therapies. In PRP’s case:

Insufficient Clinical Proof: Studies have shown mixed outcomes—some patients improve, others see no difference.
No FDA Approval for Broad Use: While PRP uses your own blood (so it’s generally safe), the FDA hasn’t cleared it for standard treatment of joint or tendon conditions.
Cost vs. Benefit: Medicare focuses on treatments proven to be effective and cost-efficient. PRP hasn’t reached that threshold yet.

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How Much Do PRP Injections Cost Without Medicare?

Since Medicare doesn’t pay, patients usually cover PRP injections out-of-pocket. Costs vary depending on location and provider:

Per Injection: $500 – $2,500
Average Series (3 injections): $1,500 – $7,500
Insurance: Most private insurers follow Medicare’s lead and don’t cover PRP.

If you need PRP for knee arthritis and your doctor recommends 3 sessions at $1,000 each, you’d pay $3,000 entirely out-of-pocket.

What About Medicare Advantage (Part C)?

Medicare Advantage (Part C) plans are offered by private insurers. They sometimes cover services beyond Original Medicare.

Reality Check: Most Medicare Advantage plans don’t cover PRP injections.
Possible Exceptions: Some plans may include PRP for wound healing or as part of experimental coverage in clinical settings.

📞 Call your Medicare Advantage provider directly and ask about PRP coverage under your plan.

Alternatives Covered by Medicare

Just because PRP isn’t covered doesn’t mean you’re out of options. Medicare does cover several proven treatments for arthritis, joint pain, and tendon injuries:

Corticosteroid Injections – Covered under Medicare Part B. Often used for knee arthritis, shoulder pain, and inflammation.
Hyaluronic Acid Injections (Viscosupplementation) – Covered for knee osteoarthritis in certain cases.
Physical Therapy – Part B covers medically necessary sessions prescribed by your doctor.
Joint Replacement Surgery – Medicare covers knee, hip, and shoulder replacements when medically necessary.
Pain Medications – Covered under Medicare Part D prescription drug plans.

These treatments may not be as cutting-edge as PRP, but they’re Medicare-approved and backed by stronger clinical evidence.

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Who Might Still Consider PRP Despite No Coverage?

Many patients still pay out-of-pocket for PRP injections when:

They’ve tried corticosteroid or hyaluronic acid shots without relief.
They want to avoid surgery (like knee replacement).
They prefer regenerative therapy over medication.
They’re athletes or highly active seniors looking for faster recovery.

While Medicare won’t pay, some patients find the investment worthwhile if PRP helps delay surgery or improves daily mobility.

Final Thought

PRP injections are not covered by Medicare for arthritis, joint pain, or tendon injuries.
The only exception is coverage for chronic non-healing wounds in clinical trials.
Costs range from $500–$2,500 per injection, and most patients pay out-of-pocket.
Medicare-approved alternatives like cortisone injections, hyaluronic acid, and physical therapy are widely available.

If you’re considering PRP, weigh the potential benefits against the cost. And don’t hesitate to discuss all treatment options with your doctor—sometimes the covered choices can be just as effective.