Medicaid Bulletin

Viltolarsen Injection, for Intravenous Use (Viltepso™) HCPCS Code J3490: Billing Guidelines

Tuesday, October 13, 2020

Effective with date of service Aug. 20, 2020, the Medicaid and NC Health Choice programs cover viltolarsen injection, for intravenous use (Viltepso™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.

Satralizumab-mwge Injection, for Subcutaneous Use (Enspryng™) HCPCS Code J3590: Billing Guidelines

Tuesday, October 13, 2020

Effective with date of service Aug. 24, 2020, the NC Medicaid and NC Health Choice programs cover satralizumab-mwge injection, for subcutaneous use (Enspryng™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3590 - Unclassified biologics.

Infliximab-axxq for Injection, for Intravenous use (Avsola™) HCPCS code Q5121: Billing Guidelines

Tuesday, October 13, 2020

Effective with date of service Sept. 11, 2020, the Medicaid and NC Health Choice programs cover infliximab-axxq for injection, for intravenous use (Avsola) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code Q5121 - Injection, infliximab-axxq, biosimilar, (avsola), 10 mg.

Belantamab Mafodotin-blmf for injection, for Intravenous use (Blenrep™) HCPCS Code J9999: Billing Guidelines

Tuesday, October 13, 2020

Effective with date of service Aug. 6, 2020, the Medicaid and NC Health Choice programs cover belantamab mafodotin-blmf for injection, for intravenous use (Blenrep™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Tafasitamab-cxix for Injection, for Intravenous Use (Monjuvi®) HCPCS Code J9999: Billing Guidelines

Tuesday, September 22, 2020

Effective with date of service Aug. 13, 2020, the Medicaid and NC Health Choice programs cover tafasitamab-cxix for injection, for intravenous use (Monjuvi®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Inebilizumab-cdon Injection, for Intravenous Use (Uplizna™) HCPCS Code J3590: Billing Guidelines

Tuesday, September 22, 2020

Effective with date of service July 27, 2020, the Medicaid and NC Health Choice programs cover inebilizumab-cdon injection, for intravenous use (Uplizna™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3590 - Unclassified biologics.

Pertuzumab, Trastuzumab and Hyaluronidase-zzxf Injection, for Subcutaneous use (Phesgo™) HCPCS Code J9999: Billing Guidelines

Tuesday, August 25, 2020

Effective with date of service July 1, 2020, the Medicaid and NC Health Choice programs cover pertuzumab, trastuzumab, and hyaluronidase-zzxf injection, for subcutaneous use (Phesgo™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Mitomycin for Pyelocalyceal Solution (Jelmyto™) HCPCS Code J9999: Billing Guidelines

Tuesday, August 25, 2020

Effective with date of service June 17, 2020, the Medicaid and NC Health Choice programs cover mitomycin for pyelocalyceal solution (Jelmyto™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Lurbinectedin for Injection, for Intravenous Use (Zepzelca™) HCPCS Code J9999: Billing Guidelines

Tuesday, August 25, 2020

Effective with date of service June 19, 2020, the Medicaid and NC Health Choice programs cover lurbinectedin for injection, for intravenous use (Zepzelca™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Bimatoprost Implant, for Intracameral Administration (Durysta™) HCPCS Code J3490: Billing Guidelines

Tuesday, August 25, 2020

Effective with date of service June 26, 2020, the Medicaid and NC Health Choice programs cover bimatoprost implant, for intracameral administration (Durysta™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.

Subscribe to Medicaid Bulletins Updates

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Associated Files