Does J9041 require prior authorization?

Yes, J9041 requires prior authorization (high confidence). At least one active policy explicitly requires prior authorization.

What is the Medicare reimbursement rate for J9041?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

Prior Auth Required

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

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Coverage of injectable oncology medications is based on NCCN Compendium Categories of Evidence and Consensus (1, 2A, 2B = proven/medically necessary; 3 = unproven/not medically necessary); if NCCN is unavailable, base decisions on FDA labeling.
Authorization of 12 months may be granted for the treatment of systemic light chain amyloidosis.
Authorization of 12 months may be granted for the treatment of relapsed or refractory follicular lymphoma.
Authorization of 12 months may be granted for the treatment of Kaposi sarcoma as subsequent therapy.
Authorization of 12 months may be granted for the treatment of relapsed or refractory Pediatric Classic Hodgkin Lymphoma.
Authorization of 12 months may be granted for treatment of POEMS syndrome in combination with dexamethasone.

ARKBLUE-BORTEZOMIB-E-G-VELCADE-303C06BF57, Bortezomib (e.g., Velcade)

BCBSNJ-DRUGS-117-4C26E16E4D, Bortezomib (Velcade)

MODA-VELCADE-38FD53BFF7, Bortezomib Velcade; Boruzu; Bortezomib§

HEALTHNET_OR-HNOR-BORTEZOMIB-BORUZU-VELCADE-CP-PHAR-410-67DA92F6E0, Bortezomib (Boruzu, Velcade); CP.PHAR.410

UMR-POL-UMR-oncology-medication-clinical-coverage-policy, Oncology Medication Clinical Coverage

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

SUREST-POL-SUREST-oncology-medication-clinical-coverage-policy, Oncology Medication Clinical Coverage

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

BCBSTN-7839defca4, Bortezomib (Velcade; Bortezomib, Boruzu)

UHC-POL-oncology-medication-clinical-coverage-policy, Oncology Medication Clinical Coverage

Ask Backwork about documentation requirements, denial risks, or coverage in your state.