This is Why Insurances Won't Cover PRP Injections
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- เผยแพร่เมื่อ 15 ก.พ. 2023
- Do Insurances Cover Platelet Rich Plasma (PRP) Injections? I review reasons why insurances may not cover PRP injections and go over what it will take for them to do so.
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Jeffrey Peng MD is a nonoperative orthopedist and sports medicine specialist. He created a TH-cam channel and blog to translate cutting edge medical knowledge and clinical research to benefit all those looking to live an active and healthy lifestyle. He focuses on maximizing non-surgical treatments for sports injuries and orthopedic conditions. He specializes in using orthobiologics and ultrasound guided minimally invasive techniques to treat osteoarthritis, tendinopathies, and musculoskeletal disorders.
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I had PRP injection (60cc) in my left shoulder over 12 months ago. I now have 100 % mobility and no pain!
I have had both PRP and Stem Cell treatments in my knees and hips using the Regenexx Protocol starting in 2016. My knees were 100% successful. My hip is a work in progress.
I have always felt that the reason it isn't covered in because the Orthopedic Surgeons do not want it to be covered.
Agree. Same protocol in my feet.
I had it done in my hip due to a tear in my one of my glute muscles that just would not heal and caused me pain during the day that worsened at night. My injury was a few yrs old when prp was injected. It was at least 6 months when i began noticing less pain at night. By a year it was completely gone. Its been about 5-6 yrs since i had it done and i have had absolutely no issues issues with my hip. Only recently have i started having pain in my hip at times, but it could be coming from the herniated disc in my back, being that it comes and goes or it depends on my activity level as well. Good luck! I think you will continue to notice an improvement.
I think you're analysis is an error. I am not an orthopedist but I know them. They are plenty busy no, the people who do not want PRP are the joint replacement providers. Those are the people for whom this is terrifying. People will always break their hips. All the Orthopedics I know are so busy. The equipment manufacturers are the ones who have the most to lose.
Why on earth would an orthopedist not want it covered? They get the money one way or the other. What is with this odd obsession over doctors gaming the system. The gaming is done by insurance companies, not doctors. Physicians often battle with insurance companies to get things covered for their patients. Their battle to get things covered through prior authorization goes unpaid and takes up a lot of time.
I sell PRP and BMAC. One of my customers told me his office would do 100 a week if Medicare and insurance paid for it. It's all natural. no negatives to it. Proven technology. Any surgeon would rather do a natural biologic procedure , especially when they know cortisone shots are bad for you. But 99.9% of patients given option of free cortisone shot versus maybe $750-$1200 cash out of pocket for PRP will choose what insurance or medicare pays for. Sad but true.
PRP is the best money I ever spent. Health insurance is a racket.
Same here. Both knees and both shoulders. Now I’m getting worsening OA in my hands. I’m going to try and get PRP for that.
I just scheduled mine and paid out of pocket . For elbow
@@forahigherlove PRP for elbow usually does very well. Shot hurts quite a bit.
PRP has changed my life!
I seriously had trouble just walking with my bad knee. Old injury from my teens turned into bone on bone at 59.
The PRP was the last hope short of cortisone or a knee replacement.
This has turned out to be a miracle for me! My wife and I are avid hikers and outdoors people. We used to walk 3-4 mph and flew by people on the trails. We do it again!
I hope YOU try it! Hope it works for you too!
Wow, amazing!
Hi, may I ask you how long after taking the injection you started feeling better again? I'm 28yrs old and I have knee since last 1yr+. No medicine or physiotherapy helped. Now Dr. suggested to take PRP injection
@@rimapaul9616...I just had PRP for two partial tears in my left rotator cuff shoulder area a month ago. I'm still experiencing achy pain and my sports doctor said it could take six months to heal. (Boxing injury 16 months ago).
Is PRP effective for arthritis (degeneration) due to aging ?
hey, can you tell me how long it took before you felt good again. I just had an injection 2 weeks ago, with 17 billion platelets and I am still stiff!! It's a strange feeling, hoping this gets better! I hope it changes my life! Ugh!
The week before Christmas I broke my heel while baking Christmas cookies. Finally had an mri in January to discover my Achilles tendon was torn in two places. One tear was almost completely separated. Doctor had two options. First option was a surgery while lying on my stomach. Second choice was PRP therapy. I chose option two. I didn't have any pain during this treatment. At eight week recheck foot doctor said it was healed. Because UF hospital in Jacksonville, Florida does so many of these treatments it was only $500.00.
Yes! PRP is a miracle for me. My knees and feet have really been helped
Our health insurance agent who is with Untied Health, as of September of 2023 PRP is covered, she showed us the bulletin from Medicare that authorized insurance companies to cover PRP,
That's very important, do you know where we can get a copy of that bulletin? Thank you
@@ritas1433 I glad you asked, time for an update, after being told several times by UH health care reps that 1 the PRP would now be covered, they refuse to pay, so we're out 750 bucks, but the rotator is much better, I would recommend PRP for rotator repair. But I'm not pleased with UH. We have contacted them several times, and have been told, they would pay, then we get a denial letter. I could not recommend United Health.
i'm pretty sure that is not true
@@devinthomas4866 What's not true? That I had PRP and it helped my rotator? That's true. That the insurance company first approved it, even gave me a confirmation number then denied the claim? That's true as well.
@@jimhollenbeck4488 No insurance, Medicare , Tricare or any other provider pays for PRP or BMAC therapy. Never has.
An office may have tried to use a C code to get something else approved, but was denied. PRP is great , I sell it. It is all cash pay or sometimes absorbed into a surgical procedure at a surgery center. Insurance does not cover it. They do in Japan, Sweden, Australia and dozens of other countries. Not here. Your FDA is making sure things are "safe". for you. What a joke.
France is the pioneer in PRP . But our insurance would rather pay for a $6 cortisone shot that destroys your joint.
I had many cortisone injections in my back, shoulders, neck, knee and I had 1 PRP. I was in lots of pain in my shoulder & neck and received trigger points along my neck and along the shoulder, plus I had one cortisone injected right in my shoulder but did not take the high pain away. 1 week later I had to go back and told the doctor they did not help. So he recommend PRP in my shoulder. I was so happy that the PRP took the high pain away. I think I should of gotten more PRP but didn’t. I had to pay $550.00 out of pocket because my insurance didn’t cover PRP’s.
Thanks for sharing
😊
I have excellent insurance coverage, Blue Cross Blue Shield but PRP was not covered. I was charged $900 for PRP injections to my left rotator cuff.
Does PRP fix the problem for good or you need to constantly take shots like cortisone?
@@mannythings5440well in my case the PRP helped with the high pain that the cortisone wouldn’t relieve. I needed surgery to fix my problem. I needed a cadaver to fix my problem in my shoulder. I don’t know if I’ll ever be 100% because I tend to get bone spurs and scar tissue can developed.
(In Martin's voice)....You Go Boy!!! This should be brought to the senate!!! Some Insurance companies would rather you live sick and unhealthy lives than live a healthy life!! Keeping you on meds and being a vicious cycle!
The fact that this info is coming from an MD means there is hope for the future. The bigger question is why is Prolotherapy not included in Med school curricula.
PRP healed me after 19 years of trying different things but nothing worked, things just got worse and I continued suffering, the things drs were offering me made things worse.
I’m finally pain free and I can’t speak highly enough of it. The best part about it is its completely natural from your own blood, no nasty synthetic chemicals. It’s well worth every cent for a pain free life.
Just be careful of the PRP method the dr uses. Do your research and ask the dr questions.
If they don’t use local anaesthetic prior to PRP treatment and an ultrasound to guide the needle, find someone that does. Don’t settle for less than that.
What is the cost?
@@quantumfx2677 I’m in Australia and it was $1200 per session, requiring 3 sessions. Although my dr only charged me $600 for the last session
excellent information. thank you
I got PRP in my knees for the first time a few days ago and the first two days had me thinking I made a mistake. Nothing crazy yet because I’m still taking it easy. Got mine at West Point since I’m on active duty. Praying this gives me relief 🥲.
definitely helped my meniscus. Took about 4 or5 weeks before I noticed
Hoping for you!
Ive had a lot of prp and its really great for ligament injuries and it does rejuvenate the synovial fluid. Outcomes can vary based on injection technique, the kits used and the number of areas per joint they injected. It works really well.
@@blarpiemanwho was your doctor
Any updates?
Graet. Awesome precentation n information. The balancing datas pro n con make things clear to be wieghing by those who need.
As a "new" way of treatment sure.. there will be a lot of debates pro n con. Just keep your awesome job escalate Doc !!!
Am entering my 3rd week of a PRP injection for arthritis in my thumb. Pain level went from tears in the eyes while playing guitar( amateur play quit a lot) Still have pain but significantly less. I have to limit my playing time or take frequent breaks . Am trying to avoid a surgery that remove the trapezium bone and use a tendon in place of that bone. Both my orthopedic surgeon and my hand specialists surgeon stress that a surgery will result in less hand strength. Couple that with carpal tunnel issues. Am planning to have corrective surgery for the carpal tunnel. Carpal tunnel is rather severe. Dropping things and great difficulties opening jars or bottles. Have lots of kitchen aides to compensate for the carpal tunnel issues.
Hey Doctor Jeff. Thank you, dude.
I think they won’t cover it because it is not pharma-based. No money involved for them. I’ve had them for a torn supranspinatus. It works!
THanks for sharing
I got PRP injection here in SYDNEY AUSTRALIA...THANKS GOD .
It's work..after 3 weeks....no more pain in my left knee..I can work properly...
I live in Sydney, just wondering how much did it cost per injection?
Dr Peng, fantastic lecture. thanks a lot. We already have so much evidence and consensus when it comes to PRP and OA, that I can't believe there are still people out there who criticize. Anyhow, intraosseous inj will come too, results are awesome, we have several studies already published and even a study explaining an in-office technique. Another study with many patients treated in office, coming :)
Biologic formulation is everything though. Centeno talks about personalized formulations because his business is preparing it for the clinics, but in vitro research does not agree with high platelet concentration and even less so with the presence of WBC, which lead the healing process to the fibrotic repair path
Awesome! Thanks for putting out more evidence to increase the body of literature
Do you have a list of evidence regarding PRP written that you can send me that I can send my current company? Thank you
My pain Dr plans to use this on me after I was in a car accident. I’m having issues with my back and neck. Worse is my neck. I’ve had my 2nd round of epidurals, steroids, nerve blocks. I’m looking forward to this. Thanks for the video. Sure helps.
I had a problem with my left knee for 6 years. 4 MRI and 8 high-class orthopedists couldn't tell me what was hurting me...(It must have been something small). Until I finally found information about PRP plasma on the Internet and found a doctor who does it with 60ml of blood, not 15ml. After the first such injection, the pain returned for 2 days for 2 months. After 2 months I had a second injection. The pain began to return after 3.5 months, but I no longer spared my knee at that time. Of course, I immediately took 3 injections... the first month passed... the knee is like new. We'll see if the pain ever comes back...
I had posted this question on your tendonitis video but since it was made a year ago I wasnt sure if it was too late to ask questions regarding that video or not. I apologize for being off the topic of what your current video is about. I have had all of the s/s stated on your myofasciitis of the forarms description for maybe 4 years now with trigger points. When I take ibuprofen the pain and swelling in the forarms goes down but then I will feel a "Strained" like sensation in my medial elbows. Is it possible to have both tendonitis in my elbow (specifically Golfers elbow) and myofascitis of the forarms? What would determine if it's actually a muscle tear instead of the other 2 options? So far MRI and other drs have found nothing despite the fact that therapists say they can physically feel something upon palpation. You are THE FIRST AND ONLY person to describe what's happening with my arms in full entirety. Everybody else just looks at them and says they don't know. And again, I apologize for asking a question about a different topic other then what the current video is about.
It is incredibly common to have BOTH myofascial trigger points AND medial or lateral epicondylopathy at the same time. Both must be treated as one often causes the other and vice versa. Just treating one will often lead to incomplete pain resolution. Hope that helps
Thank you so much for this information. I was diagnosed with Stage 4 Osteoarthritis in my right knee this past November. I have bern looking in to PRP injections, but the hospital that offers them here in Philadelphia charges $1,200 per injection. I'm also trying to find active studies PRP where I could participate.
You're welcome! Good luck
Please do a video about macrophage activation factor and vitamin D. (D3K2)
Can you please compare the benefits of tenotomy versus prp for tendonitis. Thanks.
PRP is great for chronic plantar fasciitis 😊
I am starting my PRP tomorrow. I am praying it will help, I have been struggling with DDD since my early 20s.
Whats DDD? I just had my first session out here on vacation in Colombia. It was only $75.00 and worth it
Do you have any videos on PRP and disc herniation?
What about hip OA, would it help the pain?
@JeffreyPengMD
Thoughts in nSTRIDE vs. PRP? nSTRIDE seems to be more standardized and filtered with increase concentration. Also anecdotally, less side effects (pain, large swelling).
My physician said i need a hip replacement. I am wondering if prp would be recommended? I am not a fan of surgery unless it's a must do. What do you think?
I have to figure out how to pay for PRP. I had torn the left knee and made the person that was responsible for the injury pay for it. I now have injury with the right knee and need it desperately. I can't afford it. Insurance companies are horrible. They want to charge a ton for surgery but won't cover the less invasive. I'm in pain without resolution until I get that injection. I know it works. 😩
can this be done on neck facet joints with osteopytes ?
Can you please explain PRP for TMJ osteoarthritis? Are there studies for this?
OK first of all this was brilliant. Thank you so so much. Second of all, is there a transcript of this? Something in writing that touches on all these points? I have a way of making things happen with my insurance company when I doggedly pursue an issue and give evidence of efficacy. Finally, you mentioned that a cost benefit study in the US maybe necessary for Insurance to start covering PRP injections, but I wonder, do you know when or if that even may happen? Thanks again
Click under the video where it shows the word “…more” that will open up the transcript.
Is there a PRP book for providers you recommend?
Your videos have been the most detailed I've seen explaining the PRP. I'm looking at having it done in the next week. Was diagnosed with bad case of both runners knee and jumpers knee in both knees so the tendons are pretty damaged, but overall the rest of the knee structures are pretty good. Nearly perfect cartilage and grade 2 out of 4 arthritis but that doesn't seem to be much a concern. After seeing your platelet count recommendations of 60cc draw for 10ml platelet, I assume that would mean per each knee? The dr who recommended it says they do a 50cc draw resulting in 4.7ml platelet count which seems to be on the low end of your recommendations but at least its not low dose and I have to double check that's per knee. Should I request a higher dose in my case? I'm also going to be supplementing the healing process using bpc157/tb500 peptides which I've seen some drs say they are using synergistically with PRP. I have a 3 month window I want to get the tendons healed up by if possible.
Any updates?
@@CarlosFernandez-js8yn I wound up doing the PRP, the place I had it done wasn't concerned with that high recommended platelet count as they said it was more about the quality. They said mine was about a 3 million count. But 2 months post PRP and having done 400mg/day of the BPC157/TB500 the knee specialist looking at my ultrasounds was really surprised how much they had recovered in 2 months. They were about 50% recovered, so I'm looking at maybe another 2-4 months to be at 100%. I'm also being good about sticking to the PT exercises and not doing any of the endurance climbing yet.
I had two surgeries in last years. Both are related to ligament tear . Now its been a year but although i am not satisfied with movement in muscles and flexibility. So my physio advice me to take prp should I take it or not
Surgeries are related to ankel tendon tear and
Shoulder dislocation
Hi Dr. Peng. Can you comment on platelet volume v. the volume of the injection? or is it a higher density of plateletes?
In my opinion (this is still active area of debate), platelet COUNTS is all that matters. Volume (thus concentration) can be adjusted to the desired location. For example, thumb needs a much smaller volume than a big joint like a hip. I explain more here: th-cam.com/video/NPrNeyx6Bv8/w-d-xo.html
My multi pronged approach of legs exercises from the physical therapist, Solgar No 7 supplement, deep knee squats twice a week, leg dangling twice a day, Voltaren for stiffness, and hyleronic acid injections twice a year (covered by insurance) have been enough to let me walk without excruciating pain and roll over in bed without my bones rubbing together.
I have Tricare for Life. I have arthritis in both knees. PRP was suggested by my orthopedic doctor. Thru would not cover the PRP injections
What is you're opinion on PRP for Rheumatoid arthritis? Part of my subtalar joint is effected and greatly impacting my walking. Is this something that could help this? My orthopedic doctor wants me to try this but he really doesn't knows a whole lot about the treatment.
Not a lot of research on PRP for RA
Greetings Dr. Peng, I’m a 52-year-old man, and I got PRP in my right knee 3-4 months ago for a torn meniscus & osteoarthritis. This was done at a larger hospital, and the orthopaedic doctor used the Arthrex Angel System. He drew 180 cc of blood and spun it at a 2% concentration for 6.5 cc of low concentration PRP (this is from the doctor’s notes). After the unguided PRP injection for the whole knee joint the doctor injected 5 cc of platelet poor plasma (PPP) over the right medial meniscus using ultrasound guidance. There was definite improvement of about 70-80% pain reduction, improved mobility, and a lot less limping around, but there is more healing to be done. However, at $1,000 per kit I must wonder if the doctor is using an older/inferior system to get 6.5 cc from 180 cc of blood (a big difference from the PRP blood draw vs. net platelet count chart you provided). I also asked him for as leukocyte-poor (LP-PRP) a preparation as he could provide, but when I saw the syringe the PRP wasn’t the amber color I expected, but rather it was the red-ish color of Tropical Punch Cool-Aid. When I asked him about it, he said that it was leukocyte-poor, and the color was normal. The doctor is a great guy, and I don’t want to give him any grief, but I’m wondering if I should get my future PRP elsewhere. Any advice would be appreciated.
Selphyl has a LP-PRP product which may suit your needs. 9cc blood draw, 6 mins of spin time, 4cc yield.
I just got a prp injection in my left knee. Doctor took my blood then put it in the spinning machine. But doctor never bother to look at my mri images for the torn minscus. He wslas asking the nurse what type of tear i had, and didnt mno where the tear was..didnt like that part
How do you feel about HA plus PRP versus PRP alone for osteoarthritis of the knee?
th-cam.com/video/KlPiJTyweV4/w-d-xo.html
with my respect and consideration of your opinion which I will follow in few days doing PRP for knee. when it comes to Insurance surgery means close case no need for further treatment and closes KPI. what patient really need is insurance companies change KPI for success allow open case to be considered as success. believe it or not. Insurance companies value closing case and safe legal action than patient better alternatives that doctors. Like you would consider.
Thanks for commenting
Hey Jeff, quick question for you. I had a PRP shot done for my right elbow back in February of 2023. I went through the physical therapy and everything with improvements, but something I noticed ever since I had the shot is that my right hand and forearm is slightly colder than my left hand and forearm, at least sometimes. I don't understand why this is the case. Can you help explain this?
3 weeks later, how's it going?
Could be a false sensation of cold because of your tboughts
What should the dosage be for herniated disc
Hi Dr Pang. Good video. Just what is pertinent and new. I am 70 years old. I have arthritis in both knees one less than the other. I have added your knee exercises to those those I am already doing . Exercise has definitely helped. Would PRP help with my knees? Will the PRP help with cartilage regeneration? Is stem cell therapy better than PRP at my age and in my knee situation? Finally are you based in New York?
PRP does NOT regenerate or regrow cartilage. You may find this helpful:
th-cam.com/video/JjkQvbM6rsw/w-d-xo.html
th-cam.com/video/_7HU_-YDfQY/w-d-xo.html
So, I have arthritic knees. Left one has been damaged some, so they tell me I’m bone in bone. Could o e of those shots help me? I am 67, work out hard and often, just had a cortisone shot so it is helping. But, what do you think?
Best to discuss with your docs
Cortisone will just make it worse over time.
Medicare\Kaiser Senior Advantage Plus covers the PRP shots in Full!! NO COPAYMENT AT ALL!! I know this because I have had 5 shots so far, 2 on My right knee, 2 on My right shoulder and 1 on My left shoulder with another coming next month for the left shoulder! $0 COPAYMENT!!!
I working so hard in engineering to heal my body!
Tricare only covers PRP in elbow and knees. I'm paying $1000 for my SIJ PRP treatment this week. Tricare flat out rejected it.
Correct
I paid approx. 1,600 € for 3x40cc injections with „very high concentration“. Cost for a total knee replacement were given with 12,000 to 13,000 €. It should be in the vital interest of a health insurance to avoid a replacement surgery. So, why on earth do health insurances not fund such clinical studies by themselves? … because the insured patients have to bear every cost anyway in form of their monthly contributions, there is no pressure on insurances to support better and more cost effective treatments
One last 20 years though and the other one last a year or less.
Hopefully one day soon Insurance will see the light. PRP is much more cost effective than a TKR.
VA are they willing support this theary?
Have they tried PRP in hip joints?
It is covered by medicare, If you have a medicare supplement plan and not an HMO or Advantage plan. Obviously hospitals/clinics do not want to bill of PRP, they want to pay for degenerative treatments and replacement surgeries.
In NY I pay 300$ but this is a special rate. Normally is 800$
Wow, that's amazing! There's no reason why it should be so expensive. We need to lower cost across the board to improve access. But a lot of that starts with insurance
@@JeffreyPengMD I just got a hyloronic acid yesterday which I paid $200 for. In a few weeks I’ll get my 3rd prp.
@@JeffreyPengMD when is the weight and OA video coming…with so much in the news about Ozempic I just wondered
@@leslieadler9081 It's coming! End of this month or early next month
@@JeffreyPengMD please!
My insurance declared it experimental and declined coverage. Is there a way to challenge their determination?
I just took my 1st or 3 treatments at a cost of $500 each. I figured it's an investment in my health.
Best to discuss with your health care provider, $500/injection is a great deal
I'd be absolutely thrilled to find it for $500 each time. Tried it when it was still extremely experimental ten years ago and it saved me from having a knee replacement. I went from barely walking with a cane to being able to walk fairly normally with no cane most days. Trust me when I say the cost was a whole lot more than $500, and that was ten years ago. At this point, my doctor gives me a "frequent flier" discount and it's still more than that.
you are lucky I went to see the doctor who performs PRP and he said it is 900 $ each
It’s all about money…..they cant make money from PRP which is not a drug so they make excuses
One reason abd one reason only: They can’t sell it!!! They charge you for insurance syringe needles and use of a centrifuge (maybe $200 or so). Or pharmaceuticals that have side effects and a patent!!! If they had a synthetic plasma they could charge $5,000 a pop sure but that’s what it will take!!!
I just had a PRP injecction out here on vacation in Colombia. It was only $75.00 and recommend it!
Hi Rob, where in Colombia? I had shoulder and hip PRP injections in Panama, but it was $550 per area + consult + ultrasound. Do you mind sharing the Dr.'s contact? Thanks
@@lupebutterfly9161 i went to Bogota. I answered a few people of the place but YT keeps deleting my replies i guess to not promote business. In the U.S. they charge $800-1K which is ridiculous.
Where in Columbia? Clinic name?
So... how much does this bug juice cost?
Ive heard only good things about PRP im getting mine on my hip Wednesday please pray for me and if all goes well im getting it on my back i have chronic arthritis
At you certain that Tricare covers PRP injections? My surgeon said no one does as of now
Check Tricare's website, it is covered for mild to moderate osteoarthritis.
Your doctor doesnt' want to deal with Tricare
Should the provider be using PRP kits?
Private insurnace is a scam, those people have to be in jail.
Why are they requiring me to have a driver for a PRP knee injection? There is no sedation involved.
Your joints swell. Very painful for 24 hours
Is steroids injection claimable or covered by insurance? If yes then PRP injection be covered as well.
Yes and no. They're two very, very different procedures. Any trained doctor can give you a steroid injection, no problem, and the last time I had one they reimbursed my doctor $90. For a PRP injection, they draw a very large amount of your own blood, centerfuge it down to only the platelets, then inject that into the joint. That's a very simplified explanation anyway. Way more complicated, requires special equipment and specialized training, thus much more expensive. You are trying to compare apples and oranges.
Steroids = $pharma$$$ while PRP = your own blood. You are paying the doctor for drawing, centrifuge and inject the blood. No third party pharma involved
.hi sir, I have got necrosis of my hip joint and it is the third stage.
So will my hip joint be cured with a proper Prp or stem cell?
First prp I have done by my dctr and after one month fat stem cell therapy will be done and after that again PRP will be done, will this cure my disease? plxzz Answer 🥺
@@pakistanoldakun3477 NO
@@pakistanoldakun3477 Adipose stem cell therapy interesting and looks like good idea. Govt doesn't like it though. Won't pay.
Guessing that there is no enough profit in PRP for the drug companies and, insurance companies and whoever else gets rich from our health care system. SIGH!!
Hello, yes but somebody else is profitting... why are they so expensive?
Draw blood, centrifuge, inject for minimum 500$ is crazy/rip off
Plenty of evidence there's a lot of money to be made with PRP...
Big sigh!
How can the PATIENT be sure that the doctor is injecting the correct clinical dose of 10 Billion Platelets?
No matter what you have done medically there is never the same outcome. For some it works for some it does not. Could be a drug a treatment or a surgery but not everyone gets the same exact results. Now my wife had PRP on her back and it did nothing. But that is her and her only. These insurance companies need to open there eyes. If PRP works for some or a lot they will save money on operations in the long run.
Thanks for commenting
I think it also depends on the doctor's experience. I had my first shoulder PRP and that did nothing! It wasn't even painful (the way it was this last time). Back then the doctor used a centrifuge machine that looked like a toy, he didn't even use a ultrasound machine. I questioned everything and never got a response. Paid 1,500 for nothing. Then had a real prp somewhere else and it worked!
Getting my first one in a few days. $1,500 to use my own blood. Of course not covered by insurance. Somewhat ironic.
I think that insurance companies will continue to base their opinions on results published by highly reputable scientific journals like JAMA which did NOT recommend PRP injections.
Honestly, "highly reputable scientific journal" doesn't mean all that much anymore. Some of the best papers are now being published in direct access journals that are not behind paywalls. For what it's worth, the RESTORE trial published in JAMA was fatally flawed due to low platelet counts. It's like saying acetaminophen is no better than placebo for treating pain because a study used 10mg of acetaminophen, whereas the therapeutic dose of acetaminophen is 300-1000mg. I explain more here: th-cam.com/video/NPrNeyx6Bv8/w-d-xo.html
@@JeffreyPengMDyep!! I know the docs who actual sent a rebuttal letter to this pper
Are you a big fan of Regenexx and Dr. Centeno?
I'm a big fan of research involving orthobiologics, no matter where it comes from
Because it works and you are not haveing dont have to have drugs and surgery
Prp did not work for me
I am still very skeptical of PRP injections. It has been around for decades (since the 70's) and yet, there's no set dosage for it. Also, PRP injections seem to fall short whenever there's a large trial
Kaiser does
They don't. They do cover Whole blood injections, I had one last year in January, and yesterday I had a PRP injection in my hip, which I had to pay for.
@@teresato9389 I live in So Cal and Kaiser has paid for my PRP. I just have to pay for my co-pay which is 20 bucks. Just curious, where do live and how much did you pay?
@@teresato9389 They paid for mine. 20 bucks co pay for me. Where do live? I live in So Cal. Curious, where do live?
9:25 PRP injection positive studies
Appears as if cortisone and scoping both fall into the bucket of higher probability for future degenerative impacts which ultimately give rise to knee replacements. I guess that’s what you get as you increasingly proceed down the road of socialized medicine. Rationing is only the first of many consequences as the health care market becomes totally difunctional. Maybe Congreve should fix it….no that’s how we got here.
Even if insurance is a racket, the vast majority of people have it. There's no excuse for not covering prp. The medical professionals should insist that insurance cover the cost. But, yes, medical insurance is a high yield grift.
Medicaid will cover it too, excellus blue cross blue shield! U just need a prior doctors authorization. Thank me later
Wow, I haven't seen medicaid cover it (at least not in California). What state are you in?
@@JeffreyPengMD im in NY, but i called the insurance and gave them the procedure code, they looked it up and it was on the list of being covered by insurance. Just requires prior doctors authorization
@@JeffreyPengMD i got my prp injection on my left knee yesterday, and im feeling the pain/stiffness now lol but its all good
Knees, Spine, and Hip.
Yeah why not are they not covered, PRP? (Platelet Rich Plasma ) cause it actually helps slow down progression and hold off surgeries and improves your life expectancy!
Kaiser covers PRP.
They don't. They only cover Whole blood injections. I just had a prp in my hip yesterday and had to pay for it.
Insurance companies are focussed on making money. This does not result is lower costs for us or any improvements to the quality of treatments. It's completely driven by money. I could go into details from my own experiences but will just say that if you pay attention, you will likely arrive at the same conclusion.
How can a medication that costs $1500 in Europe cost $25K in the US? =Lots of payouts along the way and political control to focus on profit.
PRP is not covered by insurance because there is no drug involved and competes with the drugs (steroids) that are in the vending machines co-owned by big pharma and insurance companies.
Insurance wants to save cash…not you