CommercialCoverageMedium impact
Prolotherapy 8.01.10
Excellus BlueCross BlueShield·Orthopedics, Pain Management, PM&R (Physical Medicine & Rehab) +2 more·Bone & Joints (Orthopedic)
Effective date
Oct 15, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has classified prolotherapy as investigational for treating musculoskeletal pain or instability, effective October 15, 2025. This means prolotherapy procedures will not be covered and claims will be denied.
Action Required
By October 15, 2025: Billing team must update system to flag prolotherapy procedures as non-covered for Excellus BlueCross BlueShield members. Stop submitting claims for prolotherapy treatments to this payer as they will be denied due to investigational status. Inform providers that prolotherapy is considered investigational and not reimbursable.