Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
J6 · Effective Oct 1, 2015
4 active Medicare policies list J0178, and 13 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
National · Effective Jul 1, 2026
J6 · Effective Jul 1, 2026
13 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 J0178 |
|---|---|---|
| Age-Related Macular Degeneration | Feb 20, 2024 | Covered |
| Glaucoma Surgery | Mar 24, 2023 | Covered |
| Policy | Effective | Status of J0178 |
|---|---|---|
| Aflibercept and Associated Biosimilar(s) | Jan 1, 2026 | Covered |
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of J0178 |
|---|---|---|
| Aflibercept and Associated Biosimilar(s) | Jan 1, 2026 | Covered |
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of J0178 |
|---|---|---|
| Aflibercept and Associated Biosimilar(s) | Jan 1, 2026 | Covered |
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of J0178 |
|---|---|---|
| Aflibercept and Associated Biosimilar(s) | Jan 1, 2026 | Covered |
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of J0178 |
|---|---|---|
| Ophthalmologic Vascular Endothelial Growth Factor (VEGF) Inhibitors | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J0178 |
|---|---|---|
| Ophthalmologic Vascular Endothelial Growth Factor (VEGF) Inhibitors | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J0178 |
|---|---|---|
| Ophthalmologic Vascular Endothelial Growth Factor (VEGF) Inhibitors | Jul 1, 2026 | Covered |