Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
J6 · Effective Oct 1, 2015
6 active Medicare policies list 11982, and 11 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
JJ · Effective Feb 19, 2023
JM · Effective Feb 19, 2023
J6 · Effective Apr 1, 2026
National · Effective Oct 1, 2025
11 policies from 7 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 11982 |
|---|---|---|
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Hormone Replacement Therapies | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 11982 |
|---|---|---|
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Hormone Replacement Therapies | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 11982 |
|---|---|---|
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Hormone Replacement Therapies | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 11982 |
|---|---|---|
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Hormone Replacement Therapies | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 11982 |
|---|---|---|
| Subcutaneous Implantable Naltrexone Pellets | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 11982 |
|---|---|---|
| Subcutaneous Implantable Naltrexone Pellets | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 11982 |
|---|---|---|
| Subcutaneous Implantable Naltrexone Pellets | Jan 1, 2026 | Covered |