States mandate their individual drug reimbursement methods. While methods vary, state Medicaid agencies usually pay for products administered in the office and hospital outpatient settings based on AWP or ASP. Medicaid payment policies for Synvisc-One^® and SYNVISC^® (hyaln G-F 20) administration and associated office visits typically are similar to those under Medicare, with reimbursement structured according to a physician fee schedule. Overall, Medicaid payment tends to be less than under Medicare or commercial payers.

Medicaid billing instructions:

• Download the Sample CMS-1500 Claim Form (PDF)
• Download the Blank CMS-1500 Claim Form (PDF)
• Download additional documents

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.