Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
J6 · Effective Oct 1, 2015
4 active Medicare policies list C9257, 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.
Free account. Policy pages stay open to everyone.
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
J6 · Effective Jul 1, 2026
National · Effective Nov 6, 2025
11 policies from 8 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of C9257 |
|---|---|---|
| Age-Related Macular Degeneration | Feb 20, 2024 | Covered |
| Cerebral Perfusion Studies | Sep 14, 2023 | Covered |
| Glaucoma Surgery | Mar 24, 2023 | Covered |
| Hypertrophic Scars and Keloids | Jun 22, 2023 | Covered |
| Policy | Effective | Status of C9257 |
|---|---|---|
| Photodynamic Therapy for Choroidal Neovascularization |
| Dec 15, 2025 |
| Covered |
| Policy | Effective | Status of C9257 |
|---|---|---|
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of C9257 |
|---|---|---|
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of C9257 |
|---|---|---|
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of C9257 |
|---|---|---|
| Ophthalmologic Vascular Endothelial Growth Factor (VEGF) Inhibitors | Jul 1, 2026 | Covered |
| Policy | Effective | Status of C9257 |
|---|---|---|
| Ophthalmologic Vascular Endothelial Growth Factor (VEGF) Inhibitors | Jul 1, 2026 | Covered |
| Policy | Effective | Status of C9257 |
|---|---|---|
| Ophthalmologic Vascular Endothelial Growth Factor (VEGF) Inhibitors | Jul 1, 2026 | Covered |