What Knee Treatments Does Medicare Cover? A Clear Guide

Dec 26, 2025

Oscar Tellez

Medicare Coverage for Knee Treatments

Introduction

For seniors dealing with chronic knee pain, one of the most common questions is, “What knee treatments does Medicare cover?” Osteoarthritis and degenerative knee problems are among the leading causes of mobility loss in older adults. While there are multiple therapies available—from corticosteroids to platelet-rich plasma (PRP) to stem cells—Medicare does not treat all of them equally.

Medicare covers traditional options like physical therapy, medications, and some injections, but it excludes most orthopedic biologics. This article takes a closer look at which knee treatments are covered, which are not, and what patients and families need to know when planning care. For a broader policy-level overview, see our parent blog Medicare Coverage for Orthobiologics.

Conservative Care First: Medicare’s Baseline Expectation

Before moving to injections or surgical options, Medicare expects patients to pursue conservative treatments for knee arthritis. This step is both clinical best practice and a requirement for reimbursement in many cases.

Covered conservative options include:

Physical therapy: Usually approved when prescribed by a physician. Sessions focus on strengthening, stretching, and mobility exercises.
Non-steroidal anti-inflammatory drugs (NSAIDs): Covered when prescribed, although many are also available as low-cost generics.
Lifestyle modifications: Weight loss programs, bracing, and supervised exercise programs may be partially reimbursed.
Assistive devices: Canes, walkers, or knee braces may be covered under durable medical equipment (DME) provisions.

Only after these approaches fail does Medicare consider injections or surgery.

Medicare Coverage for Arthritis Injections

When patients ask about Medicare coverage for arthritis injections, here’s how it breaks down:

Corticosteroid Injections – Widely covered under Medicare Part B when considered medically necessary. These injections provide short-term relief but do not alter disease progression.
Hyaluronic Acid (HA) Injections – Coverage varies. In many regions, Medicare approves HA injections for knee osteoarthritis, but patients must show they already tried conservative therapies. Local contractors make final decisions, so approval differs by state.
Platelet-Rich Plasma (PRP) – Not covered. Medicare classifies PRP as investigational for knee arthritis and other musculoskeletal conditions.
Stem Cell Injections – Excluded for orthopedic use. Only FDA-approved hematopoietic stem cell transplants are covered, and those apply to oncology, not arthritis.

This uneven coverage frustrates patients who hear about PRP and stem cells in orthopedic clinics but discover Medicare denies payment.

Medicare Coverage for Prolotherapy

Another option many patients ask about is prolotherapy, which involves injecting an irritant solution to stimulate healing. Unfortunately, Medicare does not cover prolotherapy for knee arthritis or other musculoskeletal conditions. The exclusion is based on insufficient clinical evidence and lack of FDA approval.

Our child blog Prolotherapy and Insurance: A Patient’s Guide provides more context on why most insurers—including Medicare—remain skeptical about this therapy.

Medicare Coverage for Orthopedic Biologics in Knees

When it comes to Medicare coverage for orthopedic biologics in knee treatment:

PRP: Not covered.
Stem cells: Not covered.
Hyaluronic acid: Sometimes covered, depending on contractor policies.
Prolotherapy: Not covered.

That means most regenerative knee injections are considered out-of-pocket expenses for Medicare beneficiaries. For a comparison of biologics across conditions, see our related child blog Biologics Covered by Medicare Explained.

Surgical Alternatives and Medicare

When injections fail, many patients explore surgical options. Here Medicare is more supportive:

Total knee replacement: Covered under Medicare Part A (hospital insurance) and Part B (physician services).
Partial knee replacement: Covered when medically necessary.
Arthroscopy: May be covered if deemed necessary, though recent studies question its long-term value in arthritis.

This creates a paradox: Medicare pays for expensive surgeries like knee replacement but not for lower-cost biologics like PRP. This is one reason many policy experts continue to call for reform.

Out-of-Pocket Costs for Non-Covered Knee Injections

Since most biologics are excluded, patients should plan for self-pay if they pursue regenerative options:

PRP injections: $500–$2,000 per session.
Stem cell therapy: $3,000–$8,000 per treatment.
Hyaluronic acid injections: $300–$800, though sometimes partially reimbursed.
Prolotherapy: $150–$400 per session.

Regional Cost Variations

Urban clinics: Prices are higher due to demand and facility costs.
Academic hospitals: Some patients may access treatments at reduced cost as part of clinical trials.
Private practices: Costs vary depending on the physician’s training and the equipment used.

Medicare Advantage (Part C) may occasionally expand coverage for HA injections, but PRP, stem cells, and prolotherapy remain excluded.

Patient Perspective: Living With Medicare’s Limits

For seniors and caregivers, the gap between what’s available and what’s covered can be frustrating. Many patients express concerns like:

“Why will Medicare pay for a $30,000 knee replacement but not a $1,000 PRP injection?”
“I want to avoid surgery, but I can’t afford these treatments out of pocket.”
“My doctor recommends HA, but my plan denied it—what do I do?”

Practical strategies include:

Exploring covered biologic drugs (for autoimmune arthritis rather than osteoarthritis).
Asking about appeals processes for HA denials.
Considering payment plans for PRP or stem cell therapy in private clinics.
Checking for clinical trials that may reduce costs.

Future Outlook for Knee Treatments Under Medicare

Will Medicare expand biologic coverage for knees? Experts suggest it might happen if:

FDA approvals emerge for standardized PRP or stem cell systems.
Clinical trials confirm long-term benefits in osteoarthritis.
Cost-effectiveness studies prove that injections reduce reliance on expensive joint replacements.
Policy reforms push CMS to test regenerative therapies in pilot programs.

Until then, seniors will continue to rely on traditional coverage: conservative care, corticosteroids, occasional HA injections, and surgery.

FAQs About Knee Treatments and Medicare

1. What knee treatments does Medicare cover today?
Conservative therapies, corticosteroid injections, and sometimes hyaluronic acid.

2. Does Medicare cover PRP for knee arthritis?
No, PRP is classified as investigational.

3. Does Medicare cover stem cell therapy for knees?
No, orthopedic stem cell injections are excluded.

4. Does Medicare cover prolotherapy for knees?
No, prolotherapy is not covered.

5. Does Medicare cover hyaluronic acid injections?
Sometimes—coverage depends on local contractor policies.

6. Why does Medicare cover knee replacements but not biologics?
Because surgeries are FDA-approved and supported by long-term evidence, while biologics lack standardized data.

7. Do Medicare Advantage plans cover more?
Some may expand HA coverage, but PRP, stem cells, and prolotherapy remain excluded.

Conclusion

So, what knee treatments does Medicare cover? The answer is that Medicare covers physical therapy, NSAIDs, corticosteroid injections, and in some regions hyaluronic acid injections, but excludes PRP, stem cells, and prolotherapy. Surgical options like knee replacement are fully covered, creating a gap between traditional and regenerative care.

For more insights, check out:

Medicare Coverage for Orthobiologics – parent blog with the full policy breakdown.
Biologics Covered by Medicare Explained – child blog clarifying covered vs. non-covered biologics.
Cost of Stem Cell Therapy Under Medicare – for financial planning insights.

About Me

I’m Oscar Tellez, I’ve spent the past 10 years working in regenerative medicine. My focus is on advancing safe, evidence-based applications of PRP, fat, bone marrow, birth tissues such as Wharton’s Jelly, exosomes, and cell factors.I share insights designed to help clinicians responsibly integrate regenerative care into their practice while staying compliant with FDA, FTC, and DEA guidelines.

You can connect with me directly on [Website], [LinkedIn] and [Facebook].

DISCLAIMER:
This content is for educational purposes only and is not intended as medical or legal advice. Regenerative medicine products and therapies are subject to FDA, FTC, and DEA regulations. Clinicians should verify compliance and consult with qualified professionals before offering these treatments.