Prior Authorization Requirements for Joint Injections and Trigger Point Injections
Date: 12/10/25
Effective for dates of service on or after November 1, 2025, Texas Medicaid modified the benefit criteria for joint injections and trigger point injections from pharmacy to medical covered services.
Superior HealthPlan continues to require prior authorization for these services. Effective immediately, prior authorization requests for Hyaluronate Derivatives (Viscosupplementation) for joint injections and trigger point injections should be submitted to Centene Management Company, LLC, Texas (URA #5396) for Superior Medicaid (STAR, STAR Health, STAR Kids and STAR+PLUS) and CHIP members.
A list of the applicable Viscosupplement procedure codes, options for submitting prior authorization requests for these services, and the clinical policy utilized for utilization review for these services is included below.
Viscosupplement Procedure Codes:
Procedure Codes | Procedure Code Description |
J7318 | Hyaluronan or derivative, Durolane, for intra-articular injection, 1 mg |
J7320 | Hyaluronan or derivative, GenVisc 850, for intra-articular injection, 1 mg |
J7321 | Hyaluronan or derivative, Hyalgan, Supartz, or VISCO-3, for intra-articular injection, per dose |
J7322 | Hyaluronan or derivative, Hymovis, for intra-articular injection, 1 mg |
J7323 | Hyaluronan or derivative, Euflexxa, for intra-articular injection, per dose |
J7324 | Hyaluronan or derivative, Orthovisc, for intra-articular injection, per dose |
J7325 | Hyaluronan or derivative, Synvisc or Synvisc-One, for intra-articular injection, 1 mg |
J7326 | Hyaluronan or derivative, Gel-One, for intra-articular injection, per dose |
J7327 | Hyaluronan or derivative, Monovisc, for intra-articular injection, per dose |
J7328 | Hyaluronan or derivative, Gel-Syn, for intra-articular injection, 0.1 mg |
J7329 | Hyaluronan or derivative, Trivisc, for intra-articular injection, 1 mg |
J7331 | Hyaluronan or derivative, Synojoynt, for intra-articular injection, 1 mg |
J7332 | Hyaluronan or derivative, Triluron, for intra-articular injection, 1 mg |
J3470 | Injection, hyaluronidase, Wydase, up to 150 units |
J3471 | Injection, hyaluronidase, Vitrase, ovine, preservative free, per 1 USP unit (up to 999 USP units) |
J3472 | Injection, hyaluronidase, Vitrase, ovine, preservative free, per 1000 USP units |
J3473 | Injection, hyaluronidase, Hylenex, recombinant, 1 USP unit |
Viscosupplement Prior Authorization Requests Submissions:
- Online:
- Phone: 1-800-218-7508
- Fax: 1-800-690-7030
Viscosupplement Clinical Policy:
More Information:
- Reference Superior’s Effective December 31, 2025: Clinical Policies article.
- Visit Superior’s Prior Authorization webpage to review prior authorization requirements.
- Contact Superior’s Prior Authorization department at 1-800-218-7508.