CPT J7321 · HCPCS Drug
Supartz / Hyalgan / VISCO-3 (HCPCS)
Hyaluronan or derivative, Hyalgan, Supartz or VISCO-3, for intra-articular injection, per dose.
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Rubrica tracks payor coverage for CPT J7321 (Supartz / Hyalgan / VISCO-3 (HCPCS)) across 86 payors — every Medicare MAC, the major commercial plans, the BCBS family, all 50-state Medicaid programs, and selected workers' comp and auto/PIP carriers. Aggregate coverage patterns are shown below; full payor-specific criteria, source citations, and last-reviewed dates are available to signed-in practitioners.
Top payors covering CPT J7321
Sample of 12 payors with coverage for this code. Sign in for the complete payor list, verbatim criteria, denial-risk score, and source citations for each.
| Payor | Coverage | Prior auth |
|---|---|---|
| Aetna Better Health of Florida | Covered | Prior auth |
| Aetna Better Health of Maryland | Covered | Prior auth |
| Aetna Better Health of New Jersey | Covered | Prior auth |
| Aetna Medicare Advantage | Covered | Prior auth |
| Alabama Medicaid | Covered | Prior auth |
| Alabama Medicaid (FFS) | Covered | Prior auth |
| Allstate Auto / PIP | Covered | Prior auth |
| AlohaCare | Covered | No PA |
| AmTrust Financial WC | Covered | Prior auth |
| AmeriHealth Caritas Family (ACPA / AC Northeast / Keystone First) — PA HealthChoices | Covered | Prior auth |
| Arkansas Blue Cross Blue Shield | Covered | No PA |
| Arkansas Total Care | Covered | No PA |
Coverage themes for CPT J7321
Common patterns across the 86 payors we track. Specific criteria per payor are available after sign-in.
Most payors require ≥12 weeks of conservative care before approving J7321.
14 of 86 payors require imaging concordance documentation.
Of the 86 payors with coverage records for CPT J7321, 37 require prior authorization, 25 cover without prior authorization, and 0 flag the procedure as investigational or experimental under current criteria.
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