Dexamethasone Intracanalicular Ophthalmic Insert (Dextenza®)
JJ · Effective Feb 7, 2021
10 active Medicare policies list 67028, and 23 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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JJ · Effective Feb 7, 2021
JM · Effective Feb 7, 2021
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
National · Effective Jul 1, 2026
J6 · Effective Jul 1, 2026
National · Effective Jan 1, 2025
National · Effective Nov 6, 2025
J6 · Effective Jul 1, 2026
23 policies from 6 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 67028 |
|---|---|---|
| Aflibercept and Associated Biosimilar(s) | Jan 1, 2026 | Covered |
| Avacincaptad pegol | Apr 1, 2026 | Covered |
| Brolucizumab-dbll | Sep 15, 2026 | Covered |
| Faricimab-svoa | Jan 1, 2026 | Covered |
| Intravitreal, Punctum, and Intracameral Implants | Oct 1, 2026 | Covered |
National · Effective Jan 1, 2025
| Policy | Effective | Status of 67028 |
|---|
| Aflibercept and Associated Biosimilar(s) | Jan 1, 2026 | Covered |
|---|---|---|
| Avacincaptad pegol | Apr 1, 2026 | Covered |
| Brolucizumab-dbll | Sep 15, 2026 | Covered |
| Faricimab-svoa | Jan 1, 2026 | Covered |
| Intravitreal, Punctum, and Intracameral Implants | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 67028 |
|---|---|---|
| Aflibercept and Associated Biosimilar(s) | Jan 1, 2026 | Covered |
| Avacincaptad pegol | Apr 1, 2026 | Covered |
| Brolucizumab-dbll | Sep 15, 2026 | Covered |
| Faricimab-svoa | Jan 1, 2026 | Covered |
| Intravitreal, Punctum, and Intracameral Implants | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 67028 |
|---|---|---|
| Aflibercept and Associated Biosimilar(s) | Jan 1, 2026 | Covered |
| Avacincaptad pegol | Apr 1, 2026 | Covered |
| Brolucizumab-dbll | Sep 15, 2026 | Covered |
| Faricimab-svoa | Jan 1, 2026 | Covered |
| Intravitreal, Punctum, and Intracameral Implants | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 67028 |
|---|---|---|
| Age-Related Macular Degeneration | Feb 20, 2024 | Covered |
| Fluocinolone Acetonide Intra-vitreal Implant (Retisert, Yutiq and Iluvien) | Jan 5, 2024 | Covered |
| Policy | Effective | Status of 67028 |
|---|---|---|
| Implanted Port Delivery Systems to Treat Ocular Disease | Apr 15, 2026 | Not covered |