May 31, 2021
The viscosupplement products on the Select Medication List will be updated effective Aug. 1, 2021.
Euflexxa® will be removed from the Select Medication List and be replaced by Orthovisc®. Synvisc-One® will remain on the list.
Please note reimbursement may change to reflect these product changes.
The current Select Medication List can be found on the Specialty Pharmacy section of our Provider website.
The listing of any particular drug or classification of drugs is not a guarantee of benefits. Payment of benefits is subject to several factors, including, but not limited to, eligibility at the time of service, terms, conditions, limitations and exclusions set forth in the member’s policy or benefits document. Members should refer to their contract of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any medication is between the member and their health care provider.
Euflexxa is a registered trademark of Ferring B.V. Orthovisc is a registered trademark of DePuy Synthes. Synvisc-One is a registered trademark of Genzyme Corporation.