Does Insurance Cover Genicular Artery Embolization? A Payer Tracker

The 8 policies come from four national insurers (UnitedHealthcare, Aetna, Cigna (EviCore) and HCSC), two benefit managers that review procedures for many health plans (Carelon and Evolent), and two regional plans (Blue Cross & Blue Shield of Rhode Island and Priority Health). They use different words for the same result: the plan does not pay for GAE for knee osteoarthritis under that policy.

Where each insurer stands

Public medical policies on genicular artery embolization for knee osteoarthritis, read November 12, 2026. Click a policy name to open the source.

“Experimental or investigational” and “not medically necessary” are the two usual reasons a plan gives for not paying for a procedure. Either way, the policy says the plan will not cover GAE for knee osteoarthritis. A policy is the plan’s general rule; the decision on a single claim can still depend on your plan’s contract and on an appeal.

Medicare

Original Medicare has no national coverage determination and no local coverage determination that names genicular artery embolization. The closest national policy is NCD 20.28, Therapeutic Embolization, which covers embolization in general:

“Therapeutic embolization is covered when done for hemorrhage, and for other conditions amenable to treatment by the procedure, when reasonable and necessary for the individual patient.”

We also searched the full text of every current local coverage determination in the CMS Medicare Coverage Database, including those that apply in New York. None addresses GAE; the only mentions of the genicular arteries are in the reference lists of a few policies. Without a specific policy, the Medicare contractor decides each claim on whether the procedure is reasonable and necessary for that patient. Medicare Advantage plans can set their own rules, and five documents in the table address them. Blue Cross & Blue Shield of Rhode Island lists GAE as not covered for its Medicare Advantage plans. Evolent lists Medicare Advantage among the lines of business its guideline applies to, and says its guidelines may supplement Medicare criteria where those are not fully established. Carelon says that in reviews for Medicare Advantage plans its guidelines are applied only where CMS criteria are not fully established. Priority Health says its policy applies to its Medicare members when CMS has not adopted a coverage determination. UnitedHealthcare adds prior authorization for the code generally used to bill GAE on its Medicare Advantage plans.

More on this: Does Medicare cover GAE?

What changed and when

Changes to GAE coverage policies, oldest first. Dates after the check date are announced effective dates.

Plans we could not include

• Molina Healthcare. Its public GAE policy page returned "page not found" on November 12, 2026, so we could not read the current version.
• Humana. We found no public Humana policy that states a position on GAE; its policy file we found returned an error on November 12, 2026.
• EmblemHealth, Healthfirst, Fidelis Care, Excellus BlueCross BlueShield, MVP Health Care and Oscar (New York plans). We found no public policy from these plans that names GAE. Excellus's knee pain policy (7.01.100, effective July 16, 2026) does not mention embolization. Ask these plans directly.

What this means if you are considering GAE

These policies describe what plans pay for. They do not say whether GAE is right for you; that is a medical question for you and your doctor. To check your own coverage:

• Ask your plan which policy applies to you, and whether a benefit manager such as Carelon, EviCore or Evolent reviews the request. The answer can differ from plan to plan, even within the same company.
• Ask whether prior authorization is required, and get the plan’s answer and the policy it relies on in writing.
• If a request is denied, the denial letter explains how to appeal.

How we built this tracker

• We searched the public medical policy libraries of the large national insurers, the benefit managers that review procedures for many plans, and the main New York plans, for any policy that states a position on genicular artery embolization for knee osteoarthritis.
• We included a policy only if it names GAE (or embolization of the genicular arteries) and states a coverage position. We recorded each organization’s exact wording and the date shown on the document, then grouped the positions as experimental, investigational or unproven; not medically necessary; or covered with criteria.
• Every quoted position is checked word for word against the downloaded document before the page can build. A separate check downloads each policy again from the insurer’s own site, confirms the wording sits next to the GAE entry, and recounts the totals.
• For Medicare we used the CMS Coverage API and the CMS bulk download of all current local coverage determinations, and searched their full text for the genicular arteries.
• Dates are the dates printed on each document: effective, last reviewed or last revised, as labeled. Policies were read on November 12, 2026.

Limits

• Policies change, and a newer version may exist after our check date. Always confirm with your plan.
• This is not every plan in the United States. Many plans use a benefit manager’s guideline rather than their own policy, and employer plans can set their own rules.
• A published policy is not a claim decision. We did not contact insurers, and we do not know how any single claim was decided.
• These policies are about GAE for knee osteoarthritis. Embolization for other reasons, such as bleeding, is covered under different rules.

Sources

• UnitedHealthcare: Vascular Embolization: Select Procedures (new medical policy, announced in the September 2026 Medical Policy Update Bulletin).
• Aetna: Clinical Policy Bulletin: Knee Arthroscopy / Osteoarthritis of the Knee (0673).
• Cigna: Cigna Medical Coverage Policies: Peripheral Vascular Intervention Guidelines, V2.0.2025.
• Carelon Medical Benefits Management (Elevance Health): Clinical Appropriateness Guidelines: Vascular Embolization and Occlusion Procedures (CAR15-1126.1).
• HCSC (Health Care Service Corporation): Genicular Artery Embolization (SUR705.048).
• Evolent: Evolent Clinical Guideline 7340 for Vascular Embolization or Occlusion.
• Blue Cross & Blue Shield of Rhode Island: Miscellaneous Vascular Embolization Procedures.
• Priority Health: Medical Policy: Osteoarthritis of the Knee (91571-R8).
• CMS Medicare Coverage Database: national and local coverage determinations, via the CMS Coverage API and the CMS bulk download.
• Anthem: SURG.00142, review history.
• Society of Interventional Radiology: position statement on GAE (a medical society statement, not an insurance policy).

Download the data and cite this page

Found a newer policy or a plan we missed? Tell us and we will check it and note the change here.