Key facts

  • UAE is widely recognized as a treatment for symptomatic leiomyomas; coverage still depends on plan medical-necessity rules1,2.
  • Costs vary by plan and facility; ask your insurer and the IR practice for a written estimate. Request a written estimate before treatment.
  • Denials can sometimes be overturned on appeal3.
  • A search-analytics abstract found cost was a common subcategory for UAE queries4.
  • Talk with your doctor before you decide. This information does not replace personal medical advice.

Is UFE a recognized treatment, and who decides coverage?

Uterine artery embolization (UAE, also called UFE) is widely recognized as a treatment for symptomatic leiomyomas1,2. Coverage still depends on plan medical-necessity rules, so a recognized treatment is not the same as a promise that your own plan will pay.

Why this matters: Your plan applies its own medical-necessity rules to your situation. Ask which rules apply to you before treatment, and bring the answer to your visit with questions to ask before UFE.

Questions to ask

  • Which medical-necessity rules does my plan apply to UAE for symptomatic fibroids?
  • What does my plan want from my doctor before it decides?
  • Who tells me the plan's decision, and when?

What does UFE cost?

Costs vary by plan and facility, so ask your insurer and the IR practice for a written estimate. A search-analytics abstract found cost was a common subcategory for UAE queries4. Readers should request written estimates3.

Questions to ask

  • Can you give me a written estimate before treatment?
  • Does the estimate cover the whole treatment, or only part of it?
  • Who do I contact if what I am asked to pay differs from the estimate?

Medicare and the coverage database

Medicare coverage for UAE depends on how medical necessity is documented for your case. You can search the CMS Medicare Coverage Database tool for coverage documents, and ask how your own coverage applies to you.

Questions to ask

  • Can you show me the coverage document you found for UAE?
  • If no document is listed, who decides my coverage?
  • What should I ask for in writing before treatment?

Codes your bill may show

A bill, an estimate, or an explanation of benefits lists numeric procedure codes. A code names a service. It does not say that your plan will pay for it.

One code you may see for an embolization procedure is CPT 37243. A January 2020 CMS document (MLN MM11605) prints it as vascular embolization or occlusion, with the imaging included, “for tumors, organ ischemia, or infarction”6. CMS’s 2026 Physician Fee Schedule relative value file (RVU26D, October 2026 release) lists 37243 as an active code9. Your doctor’s office can tell you which code it plans to send for your treatment. You can search a procedure code in the CMS Physician Fee Schedule Look-Up Tool7.

Medicare’s general rule for therapeutic embolization is National Coverage Determination (NCD) 20.28. It covers embolization for hemorrhage, and for other conditions the procedure can treat, when reasonable and necessary for the individual patient8. The text does not name fibroids, and it lists no procedure codes. Wording on a statement can differ from plan to plan, so ask the office to explain any line you do not recognize.

Why this matters: A code on a bill is not a coverage promise. Medicare’s coverage rules or your plan’s own rules, including whether it requires prior authorization, decide whether it pays. Ask before treatment, and keep the answer in writing.

Questions to ask

  • Which procedure codes will the office send for my treatment?
  • Does my plan require prior authorization for those codes?
  • Can I see the codes on my written estimate?

If coverage is denied

Denials can sometimes be overturned on appeal3. The federal appeals page explains how to appeal a health plan decision. Keep your written estimate with the plan's denial letter while you appeal.

Questions to ask

  • What is the deadline to appeal in my plan?
  • What should I send with an appeal?
  • Who can help me prepare an appeal?

Questions to ask before you decide

Coverage still depends on plan medical-necessity rules1,2. Talk with your doctor before you decide. Other fibroid guides are collected in the fibroid article library.

Questions to ask your doctor

  • Are my fibroids symptomatic, and how is that recorded for my plan?
  • Which other treatments should we compare before I decide, including those in non-surgical fibroid treatment?
  • What should I bring you if my plan denies coverage?

Questions to ask your health plan

  • Is UAE for symptomatic fibroids covered under my plan's medical-necessity rules?
  • Can you send me your decision and a written estimate of my share in writing?
  • If you deny coverage, how do I appeal, and by when?

Common questions

Does insurance cover UFE?

Uterine artery embolization (UAE, also called UFE) is widely recognized as a treatment for symptomatic leiomyomas1,2. Coverage still depends on plan medical-necessity rules. Talk with your doctor before you decide.

What does UFE cost?

Costs vary by plan and facility, so ask your insurer and the IR practice for a written estimate. Request a written estimate before treatment. Talk with your doctor before you decide.

Does Medicare cover UFE?

Medicare coverage for UAE depends on how medical necessity is documented for your case. You can search the CMS Medicare Coverage Database and ask how your coverage applies to you. Talk with your doctor before you decide.

What if my claim is denied?

Denials can sometimes be overturned on appeal. The federal appeals page3 explains how to appeal a health plan decision. Talk with your doctor before you decide.

Should I ask for a written estimate?

Yes. Readers should request written estimates before treatment. Keep the estimate with your plan's answer about coverage. Talk with your doctor before you decide.

Talk with your doctor before you decide. This information does not replace personal medical advice. Read the medical disclaimer.

Sources

  1. Symptomatic uterine leiomyomas, 2021 guideline (PMID 34011888) ↩︎
  2. Appropriateness criteria for fibroids (PMID 36436959) ↩︎
  3. Appealing a health plan decision, healthcare.gov ↩︎
  4. Search analytics for UAE queries, meeting abstract (DOI 10.1016/j.jvir.2022.12.356) ↩︎
  5. Medicare Coverage Database search tool, CMS
  6. CMS, MLN Matters MM11605, January 2020 OPPS update (prints the CPT embolization wording) ↩︎
  7. CMS Physician Fee Schedule Look-Up Tool overview ↩︎
  8. CMS National Coverage Determination 20.28, Therapeutic Embolization ↩︎
  9. CMS, 2026 Physician Fee Schedule relative value file RVU26D, October 2026 release (lists the code as an active code) ↩︎