Will insurance cover Genicular Artery Embolization (GAE)?

Coverage is often possible when GAE is medically necessary for knee osteoarthritis or chronic knee pain and conservative treatments have not provided lasting relief. Benefits vary by plan and payer.

Do I need preauthorization for GAE?

Many plans require prior authorization. USA Pain Center submits the clinical documentation—symptoms, imaging, and treatment history—on your behalf.

What documents help support coverage?

Recent imaging (e.g., X-ray/MRI), a record of prior treatments such as physical therapy, medications or injections, and your knee pain history help establish medical necessity.

Does Medicare cover GAE?

Medicare coverage may be available when criteria for medical necessity are met and the procedure is performed in an approved setting. We verify your benefits before scheduling.

What if my plan considers GAE investigational?

If a plan lists GAE as investigational, coverage may be denied. We explain options—including appeals, financing, and self-pay—so you can make an informed decision.

Do you offer financing or payment plans?

Yes. If coverage is partial or denied, we discuss transparent costs and available payment options, including HSA/FSA use and financing for eligible patients.

Insurance Coverage for GAE | USA Pain Center

At USA Pain Center, we’re committed to helping you access the most effective and minimally invasive treatments for chronic knee pain — including Genicular Artery Embolization (GAE). Since GAE addresses pain and inflammation related to osteoarthritis and other knee joint disorders, our team works with you to determine insurance coverage and make care affordable.

Will Insurance Cover GAE?

In many cases, yes — when GAE is deemed medically necessary for treating knee pain, inflammation, or osteoarthritis rather than purely cosmetic symptoms. This means that if your condition meets your insurance provider’s criteria (such as failed conservative treatments, clinical symptoms consistent with arthritis, imaging confirmation, etc.), the procedure can often be covered or partially covered.

As with any treatment:

Coverage depends on your particular insurance plan, whether it’s Medicare or a commercial payer.
The plan may require documentation (medical records, imaging, prior conservative therapy) to establish medical necessity..
We will help verify your benefits in advance, and assist with preauthorization whenever needed.

What We Do to Help

At USA Pain Center, we support you with:

Insurance Verification: Before scheduling your procedure, our staff will check if your plan accepts GAE and what your estimated out-of-pocket costs may be.
Preauthorization Support: We’ll work with your insurance to submit necessary documentation (symptoms, imaging, treatment history) to request approval of GAE.
Transparent Cost Discussion: If your insurance denies coverage or requires higher patient cost‐share, we’ll explain your options clearly (financing, self-pay, HSA/FSA use).
Flexible Payment Options: For eligible patients, we offer financing or payment plans to help manage any portion of the cost not covered by insurance.

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What You Should Do to Prepare

To streamline the process and optimize your coverage, we recommend:

Bring in or upload your insurance card and any recent imaging (X-ray/MRI) of your knee joint.
Provide a summary of your knee pain history, conservative treatments you’ve tried (physical therapy, injections, medications).
Allow us to obtain your benefit summary for GAE, including whether your plan requires a referral, prior authorization, or out-of-network status.
Schedule a consultation with our interventional pain specialists at USA Pain Center — we will assess your suitability for GAE and if your case meets coverage criteria.

Common Insurance Scenarios

Commercial Insurance (PPO/HMO): Many cover GAE when criteria are met; you may have a copay, deductible, or coinsurance.
Medicare: Coverage may be possible when the procedure is medically necessary for knee osteoarthritis and done in an approved facility.
Medicaid / State Plans: Coverage policies vary; we’ll check your specific state plan’s rules for novel interventional pain procedures.
Out-of-Network Providers: If USA Pain Center is out-of-network for your plan, you may have higher cost-share. We’ll help you evaluate this in advance.

Why Coverage Matters

When your insurance covers GAE, you benefit from:

A cost-effective alternative to knee-replacement surgery or long-term medication/injection strategies.
Reduced downtime and recovery compared to more invasive treatments.
Potential for meaningful pain relief and improved mobility when other treatments have failed.

Even when coverage is partial or denied, the team at USA Pain Center can help you understand the value, timing, and alternatives — so you can make an informed decision.

Next Steps

Contact USA Pain Center to schedule a consultation for GAE or use our Online Scheduling Tool that will help verify your insurance coverage at the closest location near you.

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Insurance Coverage