38 commercial payer policies list J0222. 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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38 policies from 19 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 J0222 |
|---|---|---|
| Onpattro (patisiran) | Not recorded | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Onpattro (patisiran)Effective 08/01/2025 - 08/31/2026 | Aug 1, 2025 | Prior auth requiredInferred from policy title |
| Onpattro (Patisiran)Effective 09/01/2023 - 11/30/2023 | Sep 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Onpattro (patisiran)Effective 10/01/2024 - 07/31/2025 | Oct 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Onpattro (Patisiran)Effective 12/01/2023 - 09/30/2024 | Feb 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Patisiran (Onpattro)Effective 07/01/2020 - 06/30/2021 | Jul 1, 2020 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Patisiran (Onpattro)Effective 07/01/2021 - 10/31/2022 | Jul 1, 2021 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Patisiran (Onpattro)Effective 08/01/2019 - 06/30/2020 | Aug 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
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| Patisiran (Onpattro)Effective 11/01/2022 - 08/31/2023 | Nov 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Patisiran (Onpattro)Effective 12/01/2018 - 07/31/2019 | Dec 1, 2018 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Policy | Effective | Status of J0222 |
|---|---|---|
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| RNA-Targeted Therapies (Amvuttra and Onpattro) | Jun 1, 2026 | Covered |
| RNA-Targeted Therapies (Amvuttra and Onpattro) – 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. |
| RNA-Targeted Therapies (Amvuttra and Onpattro) – 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 J0222 |
|---|---|---|
| patisiran (Onpattro) and vutrisiran (Amvuttra) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Patisiran (Onpattro) and vutrisiran (Amvuttra) | 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 J0222 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Vutrisiran (Amvuttra) and Patisiran (Onpattro) | Jan 1, 2026 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0222 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Vutrisiran (Amvuttra) and Patisiran (Onpattro) | Jan 1, 2026 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0222 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Vutrisiran (Amvuttra) and Patisiran (Onpattro) | Jan 1, 2026 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0222 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Vutrisiran (Amvuttra) and Patisiran (Onpattro) | Jan 1, 2026 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0222 |
|---|---|---|
| patisiran (Onpattro) and vutrisiran (Amvuttra) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Patisiran (Onpattro) and vutrisiran (Amvuttra) | 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 J0222 |
|---|---|---|
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| RNA-Targeted Therapies (Amvuttra and Onpattro) | Jun 1, 2026 | Covered |
| Policy | Effective | Status of J0222 |
|---|---|---|
| Treatment of Hereditary Transthyretin-mediated Amyloidosis [Patisiran (e.g., Onpattro) and Vutrisiran (e.g., Amvuttra)] | 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 J0222 |
|---|---|---|
| Vutrisiran (Amvuttra) and Patisiran (Onpattro) | Jan 1, 2026 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0222 |
|---|---|---|
| ONPATTRO (PATISIRAN) | 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 J0222 |
|---|---|---|
| Patisiran Lipid Complex (Onpattro) | Jan 31, 2019 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0222 |
|---|---|---|
| Pharmacologic Treatment of Hereditary Transthyretin-Mediated Amyloidosis (Onpattro/Tegsedi/Amvuttra) | 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 J0222 |
|---|---|---|
| hATTR medications - patisiran (Onpattro) and vutrisiran (Amvuttra) | 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 J0222 |
|---|---|---|
| Onpattro,Tegsedi and Amvuttra | 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 J0222 |
|---|---|---|
| Patisiran (Onpattro) | 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 J0222 |
|---|---|---|
| Onpattro (patisiran lipid complex) | 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 J0222 |
|---|---|---|
| RNA-Targeted Therapies (Amvuttra and Onpattro) | Jun 1, 2026 | Covered |