Commercial Insurance Payer References Do Not Substantiate Coverage Denial of Stem Cell Therapy for Orthopedic Applications.

ABSTRACT:

Background

Regenerative therapies are being studied for use in several orthopedic conditions, but as these approaches gain in popularity, insurance coverage denials have become a critical issue for patients, physicians, hospitals, and payers.

Purpose

We sought to analyze the references commercial payers use to support their policies denying coverage for orthopedic applications of mesenchymal stem cell (MSC) therapy.

Methods

We reviewed the policies regarding orthopedic applications of MSC therapy of the top 11 national commercial health insurance payers, 5 of which had publicly accessible policies. Supporting references were screened by title and/or abstract. Selected references were categorized by type of reference and reviewed for level of evidence (LOE), anatomic l

SUBMITTER: Kotlier JL 

PROVIDER: S-EPMC12325232 | biostudies-literature | 2025 Aug

REPOSITORIES: biostudies-literature