Coverage of Conditions and Treatments (Coverage Decisions)

Use this lookup tool to determine coverage decisions, or if prior authorization is needed for the treatment or condition. Note: For Self-insured employer claims, you must contact the employer or their claims administrator.

List also available in PDF format.

Archived Coverage Decisions.

See Treatment Guidelines and Resources for additional information.

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Hyaluronic acid/viscosupplementation is not a covered benefit for treatment of knee and hip osteoarthritis. 

The decision is based on the recent Health Technology Clinical Committee (HTCC) coverage determination finalized in November 2023. The committee reviewed the most recent evidence and voted to not cover hyaluronic acid/viscosupplementation for treatment of knee and hip osteoarthritis. Complete information on this HTCC determination is available at Health technology reviews | Washington State Health Care Authority  

This non-coverage decision supersedes the previous coverage decision on hyaluronic acid/viscosupplementation, covered with conditions for the treatment of pain associated with osteoarthritis of the knee, which is expired and archived. 

In adopting this new HTCC coverage determination, the Department has concluded that the determination does not conflict with any state statute. Any coverage for investigational treatment would be considered per WAC 296-20-02850. Any coverage for health technologies that have a FDA Humanitarian Device Exemption status would be considered per RCW 70.14.120 (1) (b).                              

Regulatory authority and related information