Does J9382 require prior authorization?

Yes, J9382 requires prior authorization (high confidence). At least one active policy explicitly requires prior authorization.

What is the Medicare reimbursement rate for J9382?

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

Authorize a 12-month treatment period for adults with advanced unresectable or metastatic NSCLC only if there is disease progression after prior systemic therapy and the disease is NRG1 gene fusion positive.
Authorize a 12-month treatment period for adults with advanced unresectable or metastatic pancreatic adenocarcinoma only if there is disease progression after prior systemic therapy and the disease is NRG1 gene fusion positive.

ARKBLUE-ZENOCUTUZUMAB-ZBCO-E-G-BIZENGRI-7F5E00BB75, Zenocutuzumab-zbco (e.g., Bizengri)

HEALTHNET_OR-HNOR-ZENOCUTUZUMAB-ZBCO-BIZENGRI-CP-PHAR-713-C09BE4E5E3, Zenocutuzumab-zbco (Bizengri); CP.PHAR.713

MODA-MODA-MPS-BIZENGRI-1C17B515C2, Bizengri (zenocutuzumab-zbco)

IBX-COMMERCIAL-08-02-38A-E62CC7D77D, Zenocutuzumab-zbco (Bizengri)

IBX-MEDICARE-ADVANTAGE-MA08-183A-ED58CB2492, Zenocutuzumab-zbco (Bizengri)

BCBSTN-598990a4e7, Zenocutuzumab-zbco (Bizengri)

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

AMERIHEALTH-COMMERCIAL-08-02-38A-CFF1ABEA9D, Zenocutuzumab-zbco (Bizengri)

AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-183A-F71A727B40, Zenocutuzumab-zbco (Bizengri)

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