INSURANCE REIMBURSEMENT
Use the filters below to find helpful documentation for filing with insurance providers.
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| Resource Type | Description | Provider | State | Diagnosis | Graft Location | File |
|---|---|---|---|---|---|---|
| Resource Type | Description | Provider | State | Diagnosis | Graft Location | File |
| Template letter | Wellmark BCBS SD Template Letter of Medical Necessity | Wellmark BlueCross BlueShield | South Dakota | Any | Any | Download Files |
| Template letter | Wellmark BCBS IA Template Letter of Medical Necessity | Wellmark BlueCross BlueShield | Iowa | Any | Any | Download Files |
| Summary policy | Wellmark BCBS SD Summary of Medical Criteria | Wellmark BlueCross BlueShield | South Dakota | Any | Any | Download Files |
| Summary policy | Wellmark BCBS IA Summary of Medical Criteria | Wellmark BlueCross BlueShield | Iowa | Any | Any | Download Files |
| Insurance Policy | Wellmark BCBS SD Medical Policy | Wellmark BlueCross BlueShield | South Dakota | Any | Any | Download Files |
| Insurance Policy | Wellmark BCBS IA Medical Policy | Wellmark BlueCross BlueShield | Iowa | Any | Any | Download Files |
| Template letter | United Template Letter of Medical Necessity | United | Any | Any | Any | Download Files |
| Summary policy | United Healthcare summary of medical criteria for osteochondral allografts | United | Any | Any | Any | Download Files |
| Insurance Policy | UnitedHealthcare medical policy for osteochondral grafting of the knee | United | Any | Any | Any | Download Files |
| Template letter | Independence BC PA Template Letter of Medical Necessity | Independence BlueCross | Pennsylvania | Any | Any | Download Files |
| Summary policy | Independence BlueCross PA Summary of Medical Criteria | Independence BlueCross | Pennsylvania | Any | Any | Download Files |
| Insurance Policy | Independence BlueCross PA Medical Policy | Independence BlueCross | Pennsylvania | Any | Any | Download Files |
| Insurance Policy | Independence BlueCross Medical Policy | Independence BlueCross | Any | Any | Any | Download Files |
| Template letter | Humana Template Letter of Medical Necessity | Humana | Any | Any | Any | Download Files |
| Summary policy | Humana summary of criteria for medical necessity | Humana | Any | Any | Any | Download Files |
| Insurance Policy | Humana medical coverage policy for osteochondral defect surgery | Humana | Any | Any | Any | Download Files |
| Template letter | Horizon BCBS NJ Template Letter of Medical Necessity | Horizon BlueCross BlueShield | New Jersey | Any | Any | Download Files |
| Summary policy | Horizon BlueCross BlueShield NJ Summary of Medical Criteria | Horizon BlueCross BlueShield | New Jersey | Any | Any | Download Files |
| Insurance Policy | Horizon BCBS NJ Medical Policy | Horizon BlueCross BlueShield | New Jersey | Any | Any | Download Files |
| Template letter | Highmark BS PA Template Letter of Medical Necessity | Highmark BlueShield | Pennsylvania | Any | Any | Download Files |
| Insurance Policy | Highmark BS PA Medical Policy | Highmark BlueShield | Pennsylvania | Any | Any | Download Files |
| Template letter | Highmark BCBS WV Letter of Medical Necessity | Highmark BlueCross BlueShield | West Virginia | Any | Any | Download Files |
| Template letter | Highmark BCBS PA Letter of Medical Necessity | Highmark BlueCross BlueShield | Pennsylvania | Any | Any | Download Files |
| Template letter | Highmark BCBS DE Letter of Medical Necessity | Highmark BlueCross BlueShield | Delaware | Any | Any | Download Files |
| Summary policy | Highmark BCBS PA Summary of Medical Criteria | Highmark BlueCross BlueShield | West Virginia | Any | Any | Download Files |
| Summary policy | Highmark BCBS PA Summary of Medical Criteria | Highmark BlueCross BlueShield | Pennsylvania | Any | Any | Download Files |
| Summary policy | Highmark BCBS DE Summary of Medical Criteria | Highmark BlueCross BlueShield | Delaware | Any | Any | Download Files |
| Insurance Policy | Highmark BlueCross BlueShield WV Medical Policy | Highmark BlueCross BlueShield | West Virginia | Any | Any | Download Files |
| Insurance Policy | Highmark BlueCross BlueShield PA Medical Policy | Highmark BlueCross BlueShield | Pennsylvania | Any | Any | Download Files |
| Insurance Policy | Highmark BlueCross BlueShield Delaware Medical Policy | Highmark BlueCross BlueShield | Delaware | Any | Any | Download Files |
| Template letter | Florida Blue Template Letter of Medical Necessity | Florida Blue | Florida | Any | Any | Download Files |
| Summary policy | Florida Blue Summary of Medical Criteria | Florida Blue | Florida | Any | Any | Download Files |
| Insurance Policy | Florida Blue Medical Policy | Florida Blue | Florida | Any | Any | Download Files |
| Template letter | Excellus BCBS NY Template Letter of Medical Necessity | Excellus BlueCross BlueShield | New York | Any | Any | Download Files |
| Summary policy | Excellus BCBS NY Summary of Medical Criteria | Excellus BlueCross BlueShield | New York | Any | Any | Download Files |
| Insurance Policy | Excellus BlueCross BlueShield Medical Policy | Excellus BlueCross BlueShield | New York | Any | Any | Download Files |
| Template letter | Empire BCBS NY Template Letter of Medical Necessity | Empire BlueCross BlueShield | New York | Any | Any | Download Files |
| Insurance Policy | Empire BCBS NY Medical Policy | Empire BlueCross BlueShield | New York | Any | Any | Download Files |
| Template letter | Cigna Template Letter of Medical Necessity | Cigna | Any | Any | Any | Download Files |
| Summary policy | Cigna Summary of Medical Criteria | Cigna | Any | Any | Any | Download Files |
| Insurance Policy | Cigna medical policy (CMM-312) Knee surgery - Arthroscopic and open procedures | Cigna | Any | Any | Any | Download Files |
| Template letter | CareFirst BCBS VA Template Letter of Medical Necessity | CareFirst BlueCross BlueShield | Virginia | Any | Any | Download Files |
| Template letter | CareFirst BCBS MD Template Letter of Medical Necessity | CareFirst BlueCross BlueShield | Maryland | Any | Any | Download Files |
| Template letter | CareFirst BCBS DC Template Letter of Medical Necessity | CareFirst BlueCross BlueShield | Any | Any | Any | Download Files |
| Summary policy | BCBS CareFirst VA Summary of Medical Criteria | CareFirst BlueCross BlueShield | Virginia | Any | Any | Download Files |
| Summary policy | BCBS CareFirst MD Summary of Medical Criteria | CareFirst BlueCross BlueShield | Maryland | Any | Any | Download Files |
| Summary policy | BCBS CareFirst DC Summary of Medical Criteria | CareFirst BlueCross BlueShield | Any | Any | Any | Download Files |
| Insurance Policy | CareFirst BCBS VA Medical Policy | CareFirst BlueCross BlueShield | Virginia | Any | Any | Download Files |
| Insurance Policy | CareFirst BCBS MD Medical Policy | CareFirst BlueCross BlueShield | Maryland | Any | Any | Download Files |
| Insurance Policy | CareFirst BCBS DC Medical Policy | CareFirst BlueCross BlueShield | Any | Any | Any | Download Files |
| Template letter | Capital BlueCross PA Template Letter of Medical Necessity | Capital BlueCross | Pennsylvania | Any | Any | Download Files |
| Summary policy | Capital BlueCross PA Summary of Medical Criteria | Capital BlueCross | Pennsylvania | Any | Any | Download Files |
| Insurance Policy | Capital BlueCross PA Medical Policy | Capital BlueCross | Pennsylvania | Any | Any | Download Files |
| Template letter | BS CA Template Letter of Medical Necessity | BlueShield | California | Any | Any | Download Files |
| Summary policy | Highmark BS PA Summary of Medical Criteria | BlueShield | Pennsylvania | Any | Any | Download Files |
| Summary policy | BlueShield CA Summary of Medical Criteria | BlueShield | California | Any | Any | Download Files |
| Summary policy | BS Northeastern NY Summary of Medical Criteria | BlueShield | New York | Any | Any | Download Files |
| Insurance Policy | BlueShield Northeastern NY Medical Policy | BlueShield | New York | Any | Any | Download Files |
| Template letter | BCBS BlueCare Network MI Template Letter of Medical Necessity | BlueCross BlueShield BlueCare Network | Michigan | Any | Any | Download Files |
| Summary policy | BlueCross BlueShield BlueCare Network Michigan Summary of Medical Criteria | BlueCross BlueShield BlueCare Network | Michigan | Any | Any | Download Files |
| Insurance Policy | BlueCross BlueShield BlueCare Network Michigan Medical Policy for talus | BlueCross BlueShield BlueCare Network | Michigan | Any | Talus (TS) | Download Files |
| Insurance Policy | BlueCross BlueShield BlueCare Network Michigan Medical Policy | BlueCross BlueShield BlueCare Network | Michigan | Any | Any | Download Files |
| Template letter | BCBS NE NY Template Letter of Medical Necessity | Blue Cross Blue Shield | New York | Any | Any | Download Files |
| Template letter | BCBS Western NY Template Letter of Medical Necessity | Blue Cross Blue Shield | New York | Any | Any | Download Files |
| Template letter | BCBS VT Template Letter of Medical Necessity | Blue Cross Blue Shield | Vermont | Any | Any | Download Files |
| Template letter | BCBS TN Template Letter of Medical Necessity | Blue Cross Blue Shield | Tennessee | Any | Any | Download Files |
| Template letter | BCBS SC Template Letter of Medical Necessity | Blue Cross Blue Shield | South Carolina | Any | Any | Download Files |
| Template letter | BCBS RI Template Letter of Medical Necessity | Blue Cross Blue Shield | Rhode Island | Any | Any | Download Files |
| Template letter | BCBS ND Template Letter of Medical Necessity | Blue Cross Blue Shield | North Dakota | Any | Any | Download Files |
| Template letter | BCBS NC Template Letter of Medical Necessity | Blue Cross Blue Shield | North Carolina | Any | Any | Download Files |
| Template letter | BCBS TX Template Letter of Medical Necessity | Blue Cross Blue Shield | Texas | Any | Any | Download Files |
| Template letter | BCBS OK Template Letter of Medical Necessity | Blue Cross Blue Shield | Oklahoma | Any | Any | Download Files |
| Template letter | BCBS NM Template Letter of Medical Necessity | Blue Cross Blue Shield | New Mexico | Any | Any | Download Files |
| Template letter | BCBS MT Template Letter of Medical Necessity | Blue Cross Blue Shield | Montana | Any | Any | Download Files |
| Template letter | BCBS MS Template Letter of Medical Necessity | Blue Cross Blue Shield | Mississippi | Any | Any | Download Files |
| Template letter | BCBS MO Template Letter of Medical Necessity | Blue Cross Blue Shield | Missouri | Any | Any | Download Files |
| Template letter | BCBS MN Template Letter of Medical Necessity | Blue Cross Blue Shield | Minnesota | Any | Any | Download Files |
| Template letter | BCBS MA Template Letter of Medical Necessity | Blue Cross Blue Shield | Massachusetts | Any | Any | Download Files |
| Template letter | BCBS LA Template Letter of Medical Necessity | Blue Cross Blue Shield | Louisiana | Any | Any | Download Files |
| Template letter | BCBS KS Template Letter of Medical Necessity | Blue Cross Blue Shield | Kansas | Any | Any | Download Files |
| Template letter | BCBS IL Template Letter of Medical Necessity | Blue Cross Blue Shield | Illinois | Any | Any | Download Files |
| Template letter | BCBS AZ Template Letter of Medical Necessity | Blue Cross Blue Shield | Arizona | Any | Any | Download Files |
| Template letter | BCBS AR Template Letter of Medical Necessity | Blue Cross Blue Shield | Arkansas | Any | Any | Download Files |
| Template letter | BCBS AL Template Letter of Medical Necessity | Blue Cross Blue Shield | Alabama | Any | Any | Download Files |
| Template letter | BCBS ID Template Letter of Medical Necessity | Blue Cross Blue Shield | Idaho | Any | Any | Download Files |
| Summary policy | BCBS Western NY Summary of Medical Criteria | Blue Cross Blue Shield | New York | Any | Any | Download Files |
| Summary policy | BCBS VT Summary of Medical Criteria | Blue Cross Blue Shield | Vermont | Any | Any | Download Files |
| Summary policy | BCBS TN Summary of Medical Criteria | Blue Cross Blue Shield | Tennessee | Any | Any | Download Files |
| Summary policy | BCBS SC Summary of Medical Criteria | Blue Cross Blue Shield | South Carolina | Any | Any | Download Files |
| Summary policy | BCBS RI Summary of Medical Criteria | Blue Cross Blue Shield | Rhode Island | Any | Any | Download Files |
| Summary policy | BCBS ND Summary of Medical Criteria | Blue Cross Blue Shield | North Dakota | Any | Any | Download Files |
| Summary policy | BCBS MS Summary of Medical Criteria | Blue Cross Blue Shield | Mississippi | Any | Any | Download Files |
| Summary policy | BCBS Kansas City (MO) Summary of Medical Criteria | Blue Cross Blue Shield | Missouri | Any | Any | Download Files |
| Summary policy | BCBS MN Summary of Medical Criteria | Blue Cross Blue Shield | Minnesota | Any | Any | Download Files |
| Summary policy | BCBS MA Summary of Medical Criteria | Blue Cross Blue Shield | Massachusetts | Any | Any | Download Files |
| Summary policy | BCBS LA Summary of Medical Criteria | Blue Cross Blue Shield | Louisiana | Any | Any | Download Files |
| Summary policy | BCBS KS Summary of Medical Criteria | Blue Cross Blue Shield | Kansas | Any | Any | Download Files |
| Summary policy | BCBS TX SUR705.020 Summary of Medical Criteria | Blue Cross Blue Shield | Texas | Any | Any | Download Files |
| Summary policy | BCBS OK SUR705.020 Summary of Medical Criteria | Blue Cross Blue Shield | Oklahoma | Any | Any | Download Files |
| Summary policy | BCBS NM SUR705.020 Summary of Medical Criteria | Blue Cross Blue Shield | New Mexico | Any | Any | Download Files |
| Summary policy | BCBS MT SUR705.020 Summary of Medical Criteria | Blue Cross Blue Shield | Montana | Any | Any | Download Files |
| Summary policy | BCBS IL SUR705.020 Summary of Medical Criteria | Blue Cross Blue Shield | Illinois | Any | Any | Download Files |
| Insurance Policy | BCBS Western New York Medical Policy | Blue Cross Blue Shield | New York | Any | Any | Download Files |
| Insurance Policy | BCBS Vermont Medical Policy | Blue Cross Blue Shield | Vermont | Any | Any | Download Files |
| Insurance Policy | BCBS Texas Medical Policy | Blue Cross Blue Shield | Texas | Any | Any | Download Files |
| Insurance Policy | BCBS Tennessee Medical Policy | Blue Cross Blue Shield | Tennessee | Any | Any | Download Files |
| Insurance Policy | BCBS South Carolina Medical Policy | Blue Cross Blue Shield | South Carolina | Any | Any | Download Files |
| Insurance Policy | BCBS Rhode Island Medical Policy | Blue Cross Blue Shield | Rhode Island | Any | Any | Download Files |
| Insurance Policy | BCBS Oklahoma Medical Policy | Blue Cross Blue Shield | Oklahoma | Any | Any | Download Files |
| Insurance Policy | BCBS New Mexico Medical Policy | Blue Cross Blue Shield | New Mexico | Any | Any | Download Files |
| Insurance Policy | BCBS North Dakota Medical Policy | Blue Cross Blue Shield | North Dakota | Any | Any | Download Files |
| Insurance Policy | BCBS Montana Medical Policy | Blue Cross Blue Shield | Montana | Any | Any | Download Files |
| Insurance Policy | BCBS Mississippi Medical Policy | Blue Cross Blue Shield | Mississippi | Any | Any | Download Files |
| Insurance Policy | BCBS Missouri Medical Policy | Blue Cross Blue Shield | Missouri | Any | Any | Download Files |
| Insurance Policy | BCBS Minnesota Medical Policy | Blue Cross Blue Shield | Minnesota | Any | Any | Download Files |
| Insurance Policy | BCBS Massachusetts Medical Policy | Blue Cross Blue Shield | Massachusetts | Any | Any | Download Files |
| Insurance Policy | BCBS Lousiana Medical Policy | Blue Cross Blue Shield | Louisiana | Any | Any | Download Files |
| Insurance Policy | BCBS Kansas Medical Policy | Blue Cross Blue Shield | Kansas | Any | Any | Download Files |
| Summary policy | BCBS Arizona summary of medial criteria | Blue Cross Blue Shield | Arizona | Any | Any | Download Files |
| Insurance Policy | BCBS Arizona Medical Policy | Blue Cross Blue Shield | Arizona | Any | Any | Download Files |
| Summary policy | BCBS Arkansas summary of medical criteria | Blue Cross Blue Shield | Arkansas | Any | Any | Download Files |
| Insurance Policy | BCBS Arkansas Medical Policy 2006006 Osteochondral allograft and/or mosaicplasty | Blue Cross Blue Shield | Arkansas | Any | Any | Download Files |
| Summary policy | BCBS Alabama summary of medical criteria | Blue Cross Blue Shield | Alabama | Any | Any | Download Files |
| Summary policy | BlueCross Idaho summary of medical criteria | Blue Cross Blue Shield | Idaho | Any | Any | Download Files |
| Template letter | BCBS GA Template Letter of Medical Necessity | Blue Cross Blue Shield | Georgia | Any | Any | Download Files |
| Summary policy | BCBS NC Summary of Medical Criteria | Blue Cross Blue Shield | North Carolina | Any | Any | Download Files |
| Summary policy | Empire BCBS NY CG-SURG-67 Summary of Medical Criteria | Blue Cross Blue Shield | New York | Any | Any | Download Files |
| Summary policy | BCBS of Georgia Summary of Medical Criteria | Blue Cross Blue Shield | Georgia | Any | Any | Download Files |
| Insurance Policy | Empire BCBS NY (CG-SURG-67 Treatment of Osteochondral Defects) | Blue Cross Blue Shield | New York | Any | Any | Download Files |
| Insurance Policy | BCBS of NC Autografts and Allografts | Blue Cross Blue Shield | North Carolina | Any | Any | Download Files |
| Insurance Policy | BCBS of Illinois Medical Policy (Number: SUR705.020) Autografts and Allografts | Blue Cross Blue Shield | Illinois | Any | Any | Download Files |
| Insurance Policy | BCBS GA Medial Policy (Number: CG-SURG-67) Treatmetn of Osteochondral Defects | Blue Cross Blue Shield | Georgia | Any | Any | Download Files |
| Insurance Policy | Wellmark BCBS SD Medical Policy (Number: 07.01.065) Osteochondral allografts and autografts | Blue Cross Blue Shield | South Dakota | Any | Any | Download Files |
| Insurance Policy | Wellmark BCBS of Iowa Medical Policy (Number: 07.01.065) Osteochondral allografts and autografts | Blue Cross Blue Shield | Iowa | Any | Any | Download Files |
| Insurance Policy | Blue Cross of Idaho Medical Policy (Number: 7.01.78) Autografts and allografts in the treatment of focal articular cartilage lesions | Blue Cross Blue Shield | Idaho | Any | Any | Download Files |
| Insurance Policy | Blue of California medical policy (number: 7.01.78) Autografts and allografts in the treatment of focal articular cartilage lesions | Blue Cross Blue Shield | California | Any | Any | Download Files |
| Insurance Policy | BCBS Alabama Medical Policy (Number: 248) Osteochondral autografts and allografts in treatment of focal articular cartilage lesions | Blue Cross Blue Shield | Alabama | Any | Any | Download Files |
| Literature | Publication list for osteochondral allograft transplantation of the trochlea | Any | Any | Any | Trochlea (TR) | Download Files |
| Template letter | Anthem BCBS WI Template Letter of Medical Necessity | Anthem Blue Cross Blue Shield | Wisconsin | Any | Any | Download Files |
| Template letter | Anthem BCBS VA Template Letter of Medical Necessity | Anthem Blue Cross Blue Shield | Virginia | Any | Any | Download Files |
| Template letter | Anthem BCBS OH Template Letter of Medical Necessity | Anthem Blue Cross Blue Shield | Ohio | Any | Any | Download Files |
| Template letter | Anthem BCBS NH Template Letter of Medical Necessity | Anthem Blue Cross Blue Shield | New Hampshire | Any | Any | Download Files |
| Template letter | Anthem BCBS NV Template Letter of Medical Necessity | Anthem Blue Cross Blue Shield | Nevada | Any | Any | Download Files |
| Template letter | Anthem BCBS MO Template Letter of Medical Necessity | Anthem Blue Cross Blue Shield | Missouri | Any | Any | Download Files |
| Template letter | Anthem BCBS MI Template Letter of Medical Necessity | Anthem Blue Cross Blue Shield | Michigan | Any | Any | Download Files |
| Template letter | Anthem BCBS ME Template Letter of Medical Necessity | Anthem Blue Cross Blue Shield | Maine | Any | Any | Download Files |
| Template letter | Anthem BCBS KY Template Letter of Medical Necessity | Anthem Blue Cross Blue Shield | Kentucky | Any | Any | Download Files |
| Template letter | Anthem BCBS GA Template Letter of Medical Necessity | Anthem Blue Cross Blue Shield | Georgia | Any | Any | Download Files |
| Template letter | Anthem BCBS CT Template Letter of Medical Necessity | Anthem Blue Cross Blue Shield | Connecticut | Any | Any | Download Files |
| Template letter | Anthem BCBS CO Template Letter of Medical Necessity | Anthem Blue Cross Blue Shield | Colorado | Any | Any | Download Files |
| Insurance Policy | Anthem Blue Cross CA Medical Policy | Anthem Blue Cross Blue Shield | California | Any | Any | Download Files |
| Insurance Policy | Anthem BCBS of Wisconsin Medical Policy CG-SURG-67 Treatment of Osteochondral Defects | Anthem Blue Cross Blue Shield | Wisconsin | Any | Any | Download Files |
| Insurance Policy | Anthem BCBS of Virginia Medical Policy CG-SURG-67 Treatment of Osteochondral Defects | Anthem Blue Cross Blue Shield | Virginia | Any | Any | Download Files |
| Insurance Policy | Anthem BCBS of Ohio Medical Policy CG-SURG-67 Treatment of Osteochondral Defects | Anthem Blue Cross Blue Shield | Ohio | Any | Any | Download Files |
| Insurance Policy | Anthem BCBS of Nevada Medical Policy CG-SURG-67 Treatment of Osteochondral Defects | Anthem Blue Cross Blue Shield | Nevada | Any | Any | Download Files |
| Insurance Policy | Anthem BCBS of Missouri Medical Policy CG-SURG-67 Treatment of Osteochondral Defects | Anthem Blue Cross Blue Shield | Missouri | Any | Any | Download Files |
| Insurance Policy | Anthem BCBS of Michigan Medical Policy CG-SURG-67 Treatment of Osteochondral Defects | Anthem Blue Cross Blue Shield | Michigan | Any | Any | Download Files |
| Insurance Policy | Anthem BCBS of Maine Medical Policy CG-SURG-67 Treatment of Osteochondral Defects | Anthem Blue Cross Blue Shield | Maine | Any | Any | Download Files |
| Insurance Policy | Anthem BCBS of Kentucky Medical Policy CG-SURG-67 Treatment of Osteochondral Defects | Anthem Blue Cross Blue Shield | Kentucky | Any | Any | Download Files |
| Insurance Policy | Anthem BCBS of Georgia Medical Policy CG-SURG-67 Treatment of Osteochondral Defects | Anthem Blue Cross Blue Shield | Georgia | Any | Any | Download Files |
| Insurance Policy | Anthem BCBS of Connecticut Medical Policy CG-SURG-67 Treatment of Osteochondral Defects | Anthem Blue Cross Blue Shield | Connecticut | Any | Any | Download Files |
| Insurance Policy | Anthem BCBS of Colorado Medical Policy CG-SURG-67 Treatment of Osteochondral Defects | Anthem Blue Cross Blue Shield | Colorado | Any | Any | Download Files |
| Summary policy | Anthem BCBS Wisconsin summary of criteria for osteochondral allografts | Anthem Blue Cross Blue Shield | Wisconsin | Any | Any | Download Files |
| Summary policy | Anthem BCBS Virginia summary of criteria for osteochondral allografts | Anthem Blue Cross Blue Shield | Virginia | Any | Any | Download Files |
| Summary policy | Anthem BCBS Ohio summary of criteria for osteochondral allografts | Anthem Blue Cross Blue Shield | Ohio | Any | Any | Download Files |
| Summary policy | Anthem BCBS New Hampshire summary of criteria for osteochondral allografts | Anthem Blue Cross Blue Shield | New Hampshire | Any | Any | Download Files |
| Summary policy | Anthem BCBS Nevada summary of criteria for osteochondral allografts | Anthem Blue Cross Blue Shield | Nevada | Any | Any | Download Files |
| Summary policy | Anthem BCBS Missouri summary of criteria for osteochondral allografts | Anthem Blue Cross Blue Shield | Missouri | Any | Any | Download Files |
| Summary policy | Anthem BCBS Michigan summary of criteria for osteochondral allografts | Anthem Blue Cross Blue Shield | Michigan | Any | Any | Download Files |
| Summary policy | Anthem BCBS Maine summary of criteria for osteochondral allografts | Anthem Blue Cross Blue Shield | Maine | Any | Any | Download Files |
| Summary policy | Anthem BCBS Kentucky summary of criteria for osteochondral allografts | Anthem Blue Cross Blue Shield | Kentucky | Any | Any | Download Files |
| Summary policy | Anthem BCBS Indiana summary of criteria for osteochondral allografts | Anthem Blue Cross Blue Shield | Indiana | Any | Any | Download Files |
| Summary policy | Anthem BCBS Georgia summary of criteria for osteochondral allografts | Anthem Blue Cross Blue Shield | Georgia | Any | Any | Download Files |
| Summary policy | Anthem BCBS Connecticut summary of criteria for osteochondral allografts | Anthem Blue Cross Blue Shield | Connecticut | Any | Any | Download Files |
| Summary policy | Anthem BCBS Colorado summary of criteria for osteochondral allografts | Anthem Blue Cross Blue Shield | Colorado | Any | Any | Download Files |
| Template letter | Anthem BCBS IN Template Letter of Medical Necessity | Anthem Blue Cross Blue Shield | Indiana | Any | Any | Download Files |
| Insurance Policy | Anthem BCBS of Indiana CG-SURG-67 medical policy | Anthem Blue Cross Blue Shield | Indiana | Any | Any | Download Files |
| Insurance Policy | Anthem BCBS of WI Medical (Policy Number: CG-SURG-67) Treatment of Osteochondral Defects | Anthem Blue Cross Blue Shield | Wisconsin | Any | Any | Download Files |
| Template letter | Aetna Template Letter of Medical Necessity | Aetna | Any | Any | Any | Download Files |
| Summary policy | Aetna summary of medical criteria for osteochondral allograft transplantation | Aetna | Any | Any | Any | Download Files |
| Insurance Policy | Aetna medical policy for allograft transplants of the extremities | Aetna | Any | Any | Any | Download Files |