Medicare Coverage for Cortisone Injections
Yes, Medicare Part B covers cortisone (corticosteroid) injections for joint pain and inflammation. Coverage requirements are generally less restrictive than for HA injections.
Quick Facts
| Coverage Aspect | Details |
|---|---|
| Covered? | Yes, under Part B |
| Prior Authorization | Not required |
| Your Cost | 20% coinsurance after deductible |
| Typical Out-of-Pocket | $20-$80 per injection |
| Frequency Limits | 3-4 injections per joint per year |
What Medicare Requires
Medical Necessity
Unlike HA injections, cortisone doesn’t require extensive documentation of failed conservative treatment. Medicare requires:
- Appropriate diagnosis (arthritis, bursitis, tendinitis, etc.)
- Medical necessity documentation in your records
- Medicare-enrolled provider
Covered Joints
Medicare covers cortisone injections for multiple joints:
- Knees
- Hips
- Shoulders
- Wrists/hands
- Ankles/feet
- Spine (with some restrictions)
What You’ll Pay
- Part B Deductible: $240 (2025)
- Coinsurance: 20% of Medicare-approved amount
- Typical Cost: $20-$80 per injection
Cortisone injections generally cost less than HA injections because the medication is inexpensive.
Important Frequency Considerations
While Medicare covers cortisone, there are clinical limits on how often you should receive them:
| Consideration | Guideline |
|---|---|
| Per joint per year | 3-4 injections maximum |
| Between injections | 6-12 weeks minimum |
| Lifetime concerns | Repeated use may damage cartilage |
Research Considerations
A 2019 JAMA study found patients receiving repeated cortisone injections showed greater cartilage volume loss compared to placebo. Discuss with your doctor:
- Is this your first cortisone injection?
- How many have you had in this joint?
- Are there alternative treatments to consider?
Cortisone vs. HA Injections
| Factor | Cortisone | HA Injections |
|---|---|---|
| Relief onset | Days | 2-4 weeks |
| Duration | 6-12 weeks | 6-12 months |
| Frequency limit | 3-4/year | Every 6 months |
| Cartilage impact | May harm | Neutral/protective |
| Cost | Lower | Higher |
| Medicare coverage | Easier | More documentation |
When Cortisone Makes Sense
Cortisone injections may be appropriate when:
- You need quick relief for acute inflammation
- You’re assessing whether injections help before committing to HA
- You have inflammatory conditions (not just OA)
- HA injections aren’t an option for you