Is Stem Cell Therapy Covered by Insurance?

Medically reviewed by Dr. Gaurav Goswami, MD — prepared October 2026

In most cases, no. Medicare and most private insurance plans do not cover stem cell injections for orthopedic problems such as joint, tendon, or back pain, because those uses have not been approved by the FDA and are considered investigational. Medicare’s stem cell coverage applies to transplants — such as bone marrow transplants for certain blood cancers and disorders — not to regenerative injections. As a result, most patients pay for orthopedic stem cell therapy out of pocket.

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Does Insurance Cover Stem Cell Therapy?

For orthopedic and sports-medicine uses, the short answer is usually no. If you’ve been told that stem cell therapy might help a painful knee, shoulder, hip, or back, it’s worth understanding why coverage works the way it does before you start comparing clinics. The phrase “stem cell therapy” is used for two very different kinds of treatment, and insurers treat them very differently.

The first is a stem cell transplant, such as a bone marrow transplant used to treat certain blood cancers and blood disorders. These are established medical treatments that insurance plans, including Medicare, may cover when specific criteria are met. The second is regenerative stem cell therapy: injections of concentrated cells, often taken from a patient’s own bone marrow or fat, into a joint, tendon, or the spine to help address pain and support healing. That second category is what most people mean when they search for stem cell therapy in Newport Beach, and it is the category insurers generally do not cover.

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What Does Medicare Cover When It Comes to Stem Cells?

Medicare’s coverage for stem cells is focused on transplants. According to Medicare.gov’s coverage page for transplants, Medicare Part A and Part B may cover stem cell transplants, including bone marrow transplants, along with the necessary tests, labs, and exams associated with the transplant, under certain conditions. For covered Part B services, beneficiaries generally pay 20% of the Medicare-approved amount after meeting the Part B deductible.

Regenerative stem cell injections for arthritis, tendon injuries, or back pain fall outside that transplant coverage. The FDA’s consumer alert on regenerative medicine products states that none of these products have been approved for the treatment of orthopedic conditions such as osteoarthritis, tendonitis, disc disease, back pain, hip pain, knee pain, or shoulder pain. Without an approved use, these injections are generally not covered by Medicare.

Why Don’t Private Insurers Cover Regenerative Stem Cell Injections?

Private insurers base coverage decisions largely on regulatory approval and the strength of published evidence. Plans typically classify treatments without FDA approval for a given use as experimental or investigational, and investigational treatments are commonly excluded from coverage.

The evidence picture matters, too. A 2025 Cochrane systematic review of 25 randomized trials involving 1,341 people concluded, based on low-certainty evidence, that stem cell injections for knee osteoarthritis may slightly improve pain and function compared with placebo injections, while effects on quality of life, treatment success, and the structure of the knee remain uncertain. Findings like these keep research active, but they are not the kind of settled evidence insurers usually require before adding coverage.

None of this means the treatment lacks value for every patient. It means the decision, and the cost, rests with the patient and physician rather than an insurance plan.

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How Much Do Patients Typically Pay Out of Pocket?

Because coverage is rare, cost is one of the most important practical questions, and published data offer a useful frame of reference. A survey of U.S. stem cell centers published in the Journal of Knee Surgery found that among 65 centers willing to quote a price for a single-knee injection, the average was about $5,156, with prices ranging from $1,150 to $12,000. A more recent 2025 study of orthobiologic injection pricing found a median of about $3,500 for stem cell injections among the clinics that published a price, and described the field as an out-of-pocket market with variable pricing and transparency.

Those figures are national reference points, not a quote. What a given patient pays depends on the condition, how many areas are treated, whether cells come from bone marrow or fat, whether image guidance and follow-up visits are included, and whether other treatments, such as PRP therapy, are part of the plan.

Can You Use an HSA or FSA for Stem Cell Therapy?

Some patients use funds from a health savings account (HSA) or flexible spending account (FSA) toward regenerative treatments. Whether a specific treatment qualifies depends on federal rules for eligible medical expenses and on how your plan is administered, so the safest approach is to check with your plan administrator before treatment and keep an itemized receipt that describes the service provided. If you have questions about the tax treatment of a medical expense, a tax professional can give guidance specific to your situation.

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What Should You Ask About Cost Before Treatment?

Because pricing varies so widely, a few direct questions can prevent surprises:

  • Is the quote for one area or several, and does it include every step: consultation, imaging review, cell collection, processing, and the injection itself?
  • Is the injection performed with ultrasound or fluoroscopic guidance, and is that included in the price?
  • Are follow-up visits included, and what happens if a second treatment is recommended?
  • Can I get a written, itemized estimate before scheduling?
  • Which parts of my care, if any, would be billed separately?

A practice that answers these questions clearly and in writing is usually a practice that will be transparent about the rest of your care, too. Our article on how much you’re willing to pay for excellent health looks at the value side of that equation.

How Does The Goswami Clinic Handle Payment?

The Goswami Clinic operates on a cash-pay model and does not bill insurance for regenerative treatments. Pricing is discussed openly before treatment, after Dr. Goswami has reviewed your history and imaging and recommended a specific plan. A cash-pay model also means your plan is built around your condition and goals rather than around what a particular policy will reimburse.

If you’re comparing options for joint pain or a spine condition, our team can walk you through expected costs during a free phone consultation.

Frequently Asked Questions

Does Medicare cover stem cell injections for knee pain?

Generally, no. Medicare’s coverage for stem cells applies to transplants, such as bone marrow transplants for certain blood disorders, under specific conditions. Stem cell injections for knee pain are not FDA-approved for that use, so they fall outside that coverage.

Most private plans treat orthopedic stem cell injections as investigational and exclude them. Coverage rules vary, so if you want certainty, ask your insurer for a written coverage determination before treatment.

PRP is usually paid out of pocket as well. A 2025 pricing study found median PRP prices of roughly $875 to $1,000 for a knee injection, well below typical stem cell pricing.

You can ask, but orthopedic stem cell injections are rarely reimbursed because insurers generally classify them as investigational. Contact your plan before treatment rather than after, so you know where you stand.

The Goswami Clinic is a cash-pay practice and does not bill insurance for regenerative treatments. Our team provides pricing during a free phone consultation, so you can make an informed decision before scheduling.

Have questions about cost or whether stem cell therapy fits your situation? Schedule a free phone consultation with our team.