Preferred Intra-Articular Hyaluronan Knee Injection Treatment

Effective January 1, 2023, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will update its Intra-Articular Hyaluronan Knee Injection utilization criteria to prefer Orthovisc for the treatment of osteoarthritis of the knee, in addition to the current preferred products, Synvisc and/or Synvisc-One. Durolane and Gelsyn-3 will no longer be preferred products. Any existing Durolane or Gelsyn-3 prior authorizations will be active through the original prior authorization approval date.

Learn more about Intra Hyaluronan Injections (PDF).

Actions Required Due to These Changes

Providers with members on impacted drugs should utilize these preferred products before using non-preferred products. Any members who are currently using non-preferred Durolane or Gelsyn-3 should be moved to our preferred products once their existing authorization ends.

Please continue to submit all requests via the CMM Portal for fastest processing times.