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Cortisone injections are used to treat medical conditions such as inflammation and arthritis. This treatment most often targets these conditions specifically in joints such as shoulders or knees.
If this is a treatment you are considering, a question you likely have is “does Medicare cover cortisone injections?”
In this article, we answer that question in clear, plain English. You will also find the average costs of cortisone injections if you have to pay for it out of pocket.
Does Medicare Cover Cortisone Injections?
The short answer is yes. Medicare will cover the cost of cortisone injections. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your cortisone injections. Below we look at what these are so you know what to expect.
Original Medicare Coverage
Original Medicare (Medicare Part A and Part B) provides coverage for cortisone injections. But Original Medicare only provides coverage for your cortisone injections if it is considered medically necessary.
Your healthcare provider must first order the treatment for Original Medicare to provide coverage.
Medicare Part A Coverage
Coverage for cortisone injections is provided by Medicare Part A if it is administered in an inpatient setting. Medicare Part A will cover 100 percent of the costs of hospital stays for up to 60 days.
Medicare Part B Coverage
Coverage for cortisone injections is often provided by Medicare Part B because it usually takes place in an outpatient setting. However, Medicare Part B will only provide coverage for cortisone injections if a licensed medical professional will administer it.
The healthcare provider who prescribed the drug, and the pharmacy where you buy, it must accept Medicare assignment. It must also be given as part of your healthcare provider’s service.
Once approved, Medicare Part B covers 80 percent of the costs of your cortisone injections. You will pay for the remaining 20 percent.
Medicare Part B also provides coverage for other types of injections targeting osteoarthritis besides corticosteroids (which include cortisone). These include hyaluronic acid injections and placental tissue matrix injections.
For Medicare Part B to provide coverage for these injections, you will also need to undergo an x-ray to show that you have osteoarthritis. Once approved by Medicare Part B, they will provide coverage for one injection every six months.
Part C Coverage for Cortisone Injections
Medicare Advantage plans (Medicare Part C) also provide coverage for cortisone injections. These plans have to cover everything Original Medicare covers but offer some additional benefits as well. The plans you have, however, will determine exactly what is covered and what your out-of-pocket expenses will be.
How Much Do Cortisone Injections Cost?
Cortisone injections can cost from roughly $100 to even over $1,000 if you don’t have health insurance. Factors affecting this cost include the provider, where the injection is taking place, and the condition it is treating.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare Cover Methadone?