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SYNVISC

Private Insurance

Just as coverage guidelines vary from insurer to insurer, payment for SYNVISC® is based on the individual contract between provider and payer. In general, managed care organizations pay for services according to contract-specific fee schedules, capitated rates, or a negotiated percentage of charges.



Physician's Office
Private payers may reimburse for injectable products, such as SYNVISC, however payment policies may vary based on coverage requirements for obtaining SYNVISC:

  • Stock and bill: Managed-care payers may cover SYNVISC when it is purchased and administered by the physician's office. Payers typically reimburse the physician for professional services using a fee schedule, and for SYNVISC based on contractual payment allowable.

    For billing instructions for the office setting:
    Download the Sample CMS-1500 Claim Form (PDF, 15K).

    Download more Forms & Sample Letters including a Blank CMS-1500 Claim Form (PDF, 43K).

  • Specialty pharmacy: In cases where SYNVISC must be obtained from specialty pharmacies, physicians neither bill nor receive payment for the product; payers reimburse the specialty pharmacies directly. Physicians do bill for professional services related to the administration of SYNVISC.

    View a full list of Specialty Pharmacy Order Forms.

Questions about private insurance reimbursement?
Call SYNVISC ConnectionSM at 1-800-982-8292, M-F, 9 am -6 pm (EST).

Providers retain responsibility for determining reimbursement and insurance issues related to their patients. Genzyme cannot be responsible for failure of a provider to obtain reimbursement.




Important Safety Information

SYNVISC® (hylan G-F 20) is indicated for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative nonpharmacologic therapy and simple analgesics, e.g., acetaminophen. In clinical trials, the most commonly reported adverse events were transient local pain, swelling, and/or effusion in the injected knee. In some cases, these symptoms have been extensive. Other side effects such as rash have been reported rarely.

SYNVISC is contraindicated in patients with known hypersensitivity to hyaluronan products or patients with infections in or around the knee. Use caution when using SYNVISC in patients allergic to avian proteins, feathers, or egg products; who have evidence of venous or lymphatic stasis in the leg to be treated; or who have severe inflammation in the knee joint to be treated. Patients should be advised to avoid strenuous or prolonged weight-bearing activities after treatment. Strict adherence to aseptic technique must be followed to avoid joint infection. The safety and effectiveness of SYNVISC in children and in pregnant or lactating women have not been established. It is unknown whether SYNVISC is excreted in human milk.

View the Complete Prescribing Information for SYNVISC (PDF, 146k)