Press release
SI-BONE, Inc. Announces UnitedHealthcare Adopts Exclusive iFuse Only Coverage for Minimally Invasive SI Joint Fusion
The transition to an exclusive triangular implant policy by UnitedHealthcare, the nation’s largest health insurer, is supported by over 100+ peer-reviewed
About this update from Si-bone, Inc.
[{"type":"text","content":"The transition to an exclusive triangular implant policy by UnitedHealthcare, the nation’s largest health insurer, is supported by over 100+ peer-reviewed publications, and comes as SI-BONE surpasses 60,000 iFuse procedures performed by more than 2,500 surgeons worldwide\nSANTA CLARA, Calif., Oct. 11, 2021 (GLOBE NEWSWIRE) -- SI-BONE, Inc., (Nasdaq: SIBN) a Silicon Valley-based medical device company dedicated to solving musculoskeletal disorders of the sacro-pelvic anatomy, today announced that UnitedHealthcare has changed its minimally invasive SI joint fusion policy from covering all devices to exclusively covering SI-BONE’s triangular iFuse Implants, effective October 1, 2021. UnitedHealthcare has adopted InterQual Clinical Criteria for Sacroiliac Joint Interventions, updating its policies to cover minimally invasive SI joint fusion using a Titanium Triangular Implant (i.e., iFuse Implant System). UnitedHealthcare is the largest commercial payor in the U.S. with over 45 million members, and joins Anthem, Humana and many Blue Cross Blue Shield Association health plans in requiring use of the triangular iFuse Implant System for minimally invasive SI joint fusion. With this updated policy, UnitedHealthcare joins more than 35 other health plans that collectively cover over 160 million insured, requiring the use of the iFuse Implant System for minimally invasive SI joint fusion. Nearly all other U.S. insurers now cover the procedure, generally. The revised policy provides coverage for minimally invasive sacroiliac joint fusion for the treatment of painful degenerative SI joint disease, provided certain criteria are met. Until now, UnitedHealthcare has generally covered minimally invasive SI joint fusion procedures, but has not distinguished the implant type used. The new commercial policy bulletin on minimally invasive SI joint fusion can be found here (link). This policy change follows a recent decision by Anthem, Inc., the nation’s second largest national insurer, that transitioned its MIS SI joint fusion medical policy to AIM Specialty Health, also requiring use of titanium triangular implants exclusively for SI joint fusion procedures effective July 30, 2021 (link). “UnitedHealthcare’s evidence-driven decision to cover minimally invasive SI joint fusion procedures only when using triangular titanium implants is an important s...