Does J9326 require prior authorization?

Yes, J9326 requires prior authorization (high confidence). At least one active policy explicitly requires prior authorization.

What is the Medicare reimbursement rate for J9326?

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

Emrelis is indicated for the treatment of adult patients with locally advanced or metastatic, non-squamous NSCLC with high c-Met protein overexpression [greater than or equal to 50% of tumor cells with strong (3+) staining], as determined by an FDA-approved test, who have received a prior systemic therapy.

ARKBLUE-TELISOTUZUMAB-VEDOTIN-TLLV-E-G-EMRELIS-1F58593C08, Telisotuzumab vedotin-tllv (e.g., Emrelis)

HEALTHNET_OR-HNOR-TELISOTUZUMAB-VEDOTIN-TLLV-EMRELIS-CP-PHAR-733-1BA63DCAC1, Telisotuzumab Vedotin-tllv (Emrelis); CP.PHAR.733

MODA-EMRELIS-D6A0688490, Emrelis (telisotuzumab vedotin-tllv)

IBX-COMMERCIAL-08-02-45B-BE44928AFE, Telisotuzumab vedotin-tllv (Emrelis)

IBX-MEDICARE-ADVANTAGE-MA08-040B-99A9569578, Telisotuzumab vedotin-tllv (Emrelis)

BCBSTN-12a92cb79e, Telisotuzumab vedotin-tllv (Emrelis)

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

AMERIHEALTH-COMMERCIAL-08-02-45B-1290358A0B, Telisotuzumab vedotin-tllv (Emrelis)

AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-040B-3EDD860435, Telisotuzumab vedotin-tllv (Emrelis)

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

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