All PlansCoverageLow impact
Prolotherapy
Blue Cross & Blue Shield of Mississippi·Orthopedics, Pain Management, Sports Medicine +1 more·Medical Policy
Effective date
Jan 28, 2025
We identified it
Jun 20, 2026
Summary
This policy confirms that prolotherapy for musculoskeletal pain remains investigational and non-covered. The recent update only added related policy references and updated sclerosing agent information, but the core coverage decision remains unchanged since 1997.
Action Required
By January 28, 2025: Billing team should verify that HCPCS code M0076 (Prolotherapy) is flagged as non-covered/investigational in billing system. Ensure claims for prolotherapy procedures are not submitted as they will be denied. Providers should be reminded that prolotherapy remains investigational for musculoskeletal pain treatment.