Medically reviewed by Aaron Frodsham, MD, Vascular and Interventional Radiologist
Here’s the question that stops most people between “GAE sounds like it could help my knee” and actually picking up the phone: is this going to cost me a fortune?
Short answer: genicular artery embolization is covered by many insurance plans, including Medicare. Coverage varies by insurer and individual policy, and our team verifies benefits and authorization requirements before scheduling, so you know exactly where you stand.
Here’s the longer answer, because “covered” has some moving parts worth understanding.
Why Many Insurance Plans Cover GAE
Insurance coverage tends to follow the evidence, and GAE has reached the point where major interventional radiology organizations formally support it for appropriately selected patients with knee osteoarthritis who haven’t gotten lasting relief from conservative care.
That professional backing is what moves a procedure from “experimental” to “covered.” GAE isn’t a wellness add-on or an elective extra. It’s an established, image-guided medical procedure performed by a board-certified interventional radiologist, and it’s billed and covered like one.
What Your Plan Will Want to See
Coverage is real, but it isn’t automatic. Insurers typically want to see that GAE is medically appropriate for you specifically, which usually means documentation of a few things:
- A confirmed diagnosis of knee osteoarthritis, typically on imaging
- A history of conservative treatment that hasn’t worked, such as physical therapy, anti-inflammatory medication, or injections
- Ongoing symptoms that affect your daily function
If that list looks familiar, it’s because it mirrors the medical criteria for who qualifies for GAE in the first place. That’s not a coincidence. The same evaluation that tells us whether GAE is right for your knee also builds the record your insurance plan wants to see. Good candidacy and good coverage tend to travel together.
Some plans also require prior authorization before the procedure. Our team handles that step, so you’re not the one on hold with your insurance company.
What You’ll Actually Pay
That depends on your plan, not on us. Deductibles, copays, and coinsurance vary, and where you are in your deductible year matters. We can’t tell you a number until we’ve verified your plan, and we’d be suspicious of anyone who quotes one before they have.
What we can tell you is the process: once you’re evaluated as a candidate, our team confirms your coverage, gets any required authorization, and walks you through your expected out-of-pocket cost before you commit to anything. No surprise bills, no guessing.
How GAE Compares to the Alternatives Financially
Worth thinking about in context. Knee arthritis that isn’t treated well tends to keep costing you: more injections, more medication refills, more physical therapy rounds, more days when you can’t work or move the way you want to. A knee replacement carries the cost of major surgery, a hospital stay, months of rehab, and time away from work.
GAE is an outpatient procedure. Most patients go home the same day and return to normal activity quickly. It doesn’t rule out a knee replacement later if you ever need one, but for many people it delays or removes the need for one entirely.
We’re not going to put dollar figures on that comparison, because your plan determines your numbers. But when patients ask whether GAE is “worth it,” the honest answer is that it’s covered by many plans, it’s outpatient, and it’s aimed at ending the cycle of treatments that keep you coming back.
Where GAE Is Performed
GAE at Integrated Pain Specialists is performed by Aaron Frodsham, MD, a board-certified interventional radiologist, at our Interventional Surgical Center in West Jordan. Evaluation and coverage verification happen at our Bountiful or South Jordan clinics, and your first consultation is free.
The Easiest Way to Get a Real Answer
Reading about coverage only gets you so far. The fastest path to a real number is a free consultation: we evaluate your knee, confirm whether GAE is the right fit, and verify your coverage in the same process.
If you’re over 40 with knee arthritis that conservative care hasn’t solved, that’s the next step. And if you’re still weighing options, our knee pain treatment overview lays them all out.
Frequently Asked Questions
Does Medicare cover GAE?
GAE is covered by many insurance plans, including Medicare. Coverage varies by insurer and individual policy, and our team verifies benefits and authorization requirements before scheduling.
Do I need prior authorization for GAE?
Some plans require it. Our team handles the authorization process for you as part of scheduling.
What does GAE cost out of pocket?
It depends on your plan’s deductible, copay, and coinsurance. We verify your coverage and walk you through your expected cost before you commit.
What if my insurance denies coverage for GAE?
Denials are usually about missing documentation, such as records of conservative treatment. Our team works through that with you. Ask us during your consultation and we’ll explain your options.
Is the GAE consultation free?
Yes. Your first consultation at Integrated Pain Specialists is free, and it includes the evaluation that determines both whether GAE is right for your knee and what your coverage looks like.
