Why Regenerative Medicine May Not Be Covered by Insurance
Many regenerative medicine treatments are considered elective, specialty, or non-covered services by insurance plans. Coverage can vary depending on the treatment, diagnosis, insurance carrier, and individual plan.
Treatments such as PRP therapy, Cell Therapy: MFAT & BMAC, EMTT and shockwave therapy, Tenex, TenJet, Sonex carpal tunnel release, and other specialty procedures may not be covered in the same way as traditional medical services.
Because every plan is different, Maple Medical will help explain what is known about your recommended treatment and what costs should be reviewed before care begins.
What Costs Are Reviewed Before Treatment
If Dr. Blatz recommends treatment, our team will review expected costs before treatment begins. This may include the recommended therapy, procedure, treatment series, follow-up needs, or other parts of your care plan when applicable.
Your cost conversation may include:
- The treatment being recommended
- Why the treatment may be appropriate for your condition
- Whether multiple visits or a treatment series may be involved
- What is included in the recommended plan
- Expected out-of-pocket costs
- Accepted payment methods
- Any next steps before scheduling treatment
You should have the opportunity to understand the recommendation and ask questions before making a decision.
Accepted Payment Methods
Maple Medical accepts:
- Debit Card
- Credit Card
- Check
- Health Savings Accounts (HSA)
- Flexible Spending Accounts (FSA)
If you have questions about payment before your appointment or before scheduling treatment, our team can help explain what information will be reviewed.
Insurance and Your Consultation
Your consultation is designed to help Dr. Blatz better understand your symptoms, prior care, goals, medical history, and whether regenerative medicine or another non-surgical option may be appropriate.
The consultation fee for new patients is $350 and includes: a 60-minute comprehensive evaluation, diagnostic ultrasound (when appropriate), advanced imaging review (MRI, X-ray, CT, etc., if available), a discussion of treatment recommendations & candidacy, as well as a trial of shockwave therapy (when appropriate).
A treatment recommendation is made after evaluation. If a recommended treatment is not covered by insurance, our team will explain expected costs before treatment begins.
If you have insurance-related questions, please bring your insurance information and any relevant medical records, imaging reports, or previous treatment notes to your consultation.
Treatment Pricing
Treatment pricing depends on the recommended care plan. Because every patient’s condition, treatment needs, and goals are different, Maple Medical does not use a one-size-fits-all pricing approach.
Your plan may include one treatment or a coordinated care pathway involving options such as PRP therapy, Cell Therapy: MFAT & BMAC, EMTT and shockwave therapy, Tenex, TenJet, Sonex carpal tunnel release, physical therapy coordination, follow-up care, or at-home support when appropriate.
Once Dr. Blatz has evaluated your condition and discussed your options, our team can review expected costs before care begins.
For example, a 30-minute shockwave therapy session is $200 and an EMTT session is $95. Please ask our team about discounted treatment bundles when prepaying in full.
Questions to Ask Before Moving Forward
Before beginning treatment, you may want to ask:
- What treatment is being recommended?
- Why is this treatment being recommended for my condition?
- What are the expected costs?
- Is this likely to be covered by insurance?
- How many visits may be involved?
- What should I expect before, during, and after treatment?
- Are there follow-up visits or recovery recommendations?
- Are there other options I should consider?
At Maple Medical, we want you to feel comfortable asking questions. A clear understanding of the plan is an important part of making an informed decision.
Advanced, Regenerative Care & Pain Management for Lake Oswego and Portland Patients
Maple Medical is located in Lake Oswego and serves patients from Portland and nearby communities who are looking for a more personalized approach to regenerative medicine and non-surgical musculoskeletal care.
Patients often come to Maple Medical because they want advanced treatment options, clear guidance, and a more transparent conversation before moving forward with care.
Take the Next Step
If you are considering regenerative medicine or another specialty treatment at Maple Medical, our team can help you understand what to expect from the consultation, treatment planning, and cost review process.
Before treatment begins, you will have the opportunity to review expected costs and ask questions so you can make an informed decision about your care.
