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Patient Insurance Process*

MyCartilageCare can provide patient support by helping to manage the insurance process. MyCartilageCare provides patient benefit investigation, predetermination/prior authorization assistance, and reimbursement support.

Step 1

Download and complete Patient Enrollment Form. Submit Patient Enrollment Form and all requested documentation to MyCartilageCare. For guidance, please see the MyCartilageCare Dictation Roadmap, located in the Resource Library.

Step 2

From the list below, select patient’s specific insurance carrier for medical inclusion criteria (if carrier is not listed, please call MyCartilageCare at 877-872-4643 for more information). For patients who do not meet the specific criteria of their insurer, additional documentation should be submitted with the Patient Enrollment Form. Letter of Medical Necessity Guidance and a Letter of Medical Necessity Template are included in the Resource Library.

Please choose patient insurer:

Step 3

Fax the completed patient enrollment form to MyCartilageCare at 855-803-9485.

*Nothing contained herein is intended, nor should it be construed, to suggest a guarantee of coverage or reimbursement for any product or service. Check with the individual insurance provider regarding coverage.

Resource Library

Materials are available to help support insurance reimbursement and billing. Additional questions may be directed to MyCartilageCare at 877-872-4643.

A MyCartilageCare Case Manager

A dedicated MyCartilageCare Case Manager is committed to offering comprehensive support tailored to your individual insurance requirements and treatment goals. Call 877-872-4643 or email .

Indication and Important Safety Information

Important Safety Information

Contraindications: MACI is contraindicated in patients with a known history of hypersensitivity to gentamicin, other aminoglycosides, products of porcine or bovine origin; in patients with severe osteoarthritis of the knee, inflammatory arthritis, inflammatory joint disease, or uncorrected congenital blood coagulation disorders; in patients who have undergone prior knee surgery in the past 6 months, excluding surgery to procure a biopsy or a concomitant procedure to prepare the knee for a MACI implant; or in patients unable to cooperate with a physician-prescribed post-surgical rehabilitation program.

Warnings and Precautions:
  • Malignancy: The risk of MACI in patients with malignancy in the area of cartilage biopsy or implant is unknown. Expansion of malignant or dysplastic cells present in biopsy tissue during manufacture and subsequent implantation may be possible.
  • Transmissible infectious diseases: Because patients undergoing procedures associated with MACI are not routinely tested for transmissible infectious diseases, cartilage biopsy and MACI implant may carry risk of transmitting infectious diseases.
  • Presurgical Comorbidities: Local inflammation or active infection in the bone, joint, and surrounding soft tissue, meniscal pathology, cruciate ligament instability, and misalignment should be assessed and treated prior to or concurrent with MACI implantation.
  • Product Sterility: Final sterility test results are not available at the time of shipping.

Adverse Reactions: The most frequently occurring adverse reactions reported for MACI (≥5%) were arthralgia, tendonitis, back pain, joint swelling, and joint effusion. Serious adverse reactions reported for MACI were arthralgia, cartilage injury, meniscus injury, treatment failure, and osteoarthritis.

Specific Populations:
  • Use of MACI in pediatric patients (younger than 18 years of age) or in patients over 65 years of age has not been established.
  • The MACI implant is not recommended during pregnancy. For implantations post-pregnancy, the safety of breastfeeding to an infant has not been determined.

To report negative side effects, contact Vericel Corporation at 1-800-453-6948 or FDA at 1-800-FDA-1088 (1-800-332-1088) or www.fda.gov/medwatch.

Please see Full Prescribing Information.

Indication

MACI® is an autologous cellularized scaffold product indicated for the repair of single or multiple symptomatic, full-thickness cartilage defects of the knee with or without bone involvement in adults.

MACI® (autologous cultured chondrocytes on porcine collagen membrane) is an autologous cellularized scaffold product indicated for the repair of single or multiple symptomatic, full-thickness cartilage defects of the knee with or without bone involvement in adults.

Limitations of Use

Effectiveness of MACI in joints other than the knee has not been established.

Safety and effectiveness of MACI in patients over the age of 55 years have not been established.