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HCPCS/CPT J0894, Injection, decitabine, 1 mg | Prior Auth Required

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`J0894`, Injection, decitabine, 1 mg

HCPCS/CPT

Prior Authorization

Prior Auth Required

At least one active policy explicitly requires prior authorization (high confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

3 Active Policies

HEALTHNET_OR-HNOR-DECITABINE-CEDAZURIDINE-INQOVI-CP-PHAR-479-6015FFD09C, Decitabine-Cedazuridine (Inqovi); CP.PHAR.479

OR

EVICORE-HPLAN-CIGNA-729A536F50C8, Q3 - 2026 Cigna MedOnc Master Drug List.pdf

EVICORE-HPLAN-HEALTH_PARTNERS_PLANS-4BC80209CCC5, Q3 - 2026 Jefferson Health Plans MedOnc Master Drug List

Related Codes

C9399(2 policies)J0870(2 policies)J0209(2 policies)J0584(2 policies)J0208(2 policies)J0641(2 policies)J0642(2 policies)J0881(2 policies)

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