Billing and Coding: Instructions for Lemtrada (alemtuzumab) When Used in the Treatment of Relapsing Multiple Sclerosis
National · Effective Oct 1, 2025
1 active Medicare policy lists J0202, and 36 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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National · Effective Oct 1, 2025
36 policies from 21 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Codes labeled “Inferred from policy title” are not listed in the policy document; Backwork attached them because the policy title names the drug.
| Policy | Effective | Status of J0202 |
|---|---|---|
| Alemtuzumab (Lemtrada)Effective 01/01/2019 - 05/31/2019 | Jan 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Alemtuzumab (Lemtrada)Effective 02/01/2023 - 05/31/2023 | Feb 1, 2023 | Prior auth requiredInferred from policy title |
| Alemtuzumab (Lemtrada)Effective 03/01/2022 - 01/31/2023 | Mar 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Alemtuzumab (Lemtrada)Effective 04/01/2021 - 02/28/2022 | Apr 1, 2021 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Alemtuzumab (Lemtrada)Effective 05/01/2020 - 03/31/2021 | May 1, 2020 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Alemtuzumab (Lemtrada)Effective 06/01/2019 - 04/30/2020 | Jun 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Alemtuzumab (Lemtrada)Effective 06/01/2023 - 04/30/2024 | Jun 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Lemtrada (alemtuzumab) | Not recorded | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Lemtrada (alemtuzumab)Effective 05/01/2024 - 04/30/2025 | May 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Lemtrada (alemtuzumab)Effective 05/01/2025 - 04/30/2026 | May 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Policy | Effective | Status of J0202 |
|---|---|---|
| Lemtrada (Alemtuzumab) | Apr 1, 2026 | Covered |
| Lemtrada (Alemtuzumab) – Commercial and Individual Exchange Medical Benefit Drug Policy | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Lemtrada (Alemtuzumab) – Community Plan Medical Benefit Drug Policy | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Guillain-Barre Syndrome Treatments | Sep 22, 2023 | Covered |
| Lung Transplantation | Sep 7, 2023 | Covered |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Alemtuzumab (Lemtrada) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Alemtuzumab (Lemtrada) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Alemtuzumab (Lemtrada) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Alemtuzumab (Lemtrada) – Minnesota Health Care Programs | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Alemtuzumab (Lemtrada) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Alemtuzumab (Lemtrada) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Alemtuzumab (e.g., Lemtrada) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Alemtuzumab | Mar 1, 2026 | Covered |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Alemtuzumab | Mar 1, 2026 | Covered |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Alemtuzumab | Mar 1, 2026 | Covered |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Alemtuzumab | Mar 1, 2026 | Covered |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Alemtuzumab Lemtrada | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Alemtuzumab (Lemtrada) | Feb 5, 2015 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Alemtuzumab (Lemtrada) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Alemtuzumab (Lemtrada); CP.PHAR.243 | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Lemtrada (Alemtuzumab) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0202 |
|---|---|---|
| 00448 alemtuzumab (Lemtrada) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Lemtrada (alemtuzumab) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Lemtrada (Alemtuzumab) (PG226, Ver. 4) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Lemtrada (Alemtuzumab) | Apr 1, 2026 | Covered |
| Policy | Effective | Status of J0202 |
|---|---|---|
| Lemtrada (Alemtuzumab) | Apr 1, 2026 | Covered |