15 commercial payer policies list J0801. 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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15 policies from 13 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 J0801 |
|---|---|---|
| Acthar Gel (repository corticotropin injection) | Jan 1, 2026 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Acthar Gel (repository corticotropin injection)Effective 02/01/2024 - 01/31/2025 | Feb 1, 2024 | Prior auth requiredInferred from policy title |
| Acthar Gel (repository corticotropin injection)Effective 02/01/2025 - 12/31/2025 | Feb 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 J0801 |
|---|---|---|
| Repository Corticotropin Injection (Acthar Gel and Purified Cortrophin Gel) | Nov 10, 2023 | Covered |
| Policy | Effective | Status of J0801 |
|---|---|---|
| Repository Corticotropin Injection (Acthar Gel, Purified Cortrophin Gel) | 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 J0801 |
|---|---|---|
| H.P. ACTHAR GEL (REPOSITORY CORTICOTROPIN INJECTION) | 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 J0801 |
|---|---|---|
| Repository Corticotropin Intramuscular Injection Acthar GEL | 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 J0801 |
|---|---|---|
| Corticotropin-ACTH: [HP Acthar Gel (repository corticotropin injection), Cortrophin Gel | Sep 14, 2008 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0801 |
|---|---|---|
| Corticotropin (H.P. Acthar, Purified Cortrophin Gel) | 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 J0801 |
|---|---|---|
| H.P. Acthar Gel | 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 J0801 |
|---|---|---|
| Repository Corticotropin Injection (Acthar Gel, Purified Cortrophin Gel) | 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 J0801 |
|---|---|---|
| Corticotropin-ACTH: Acthar Gel (repository corticotropin injection) Cortrophin Gel (repository corticotropin injection) | 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 J0801 |
|---|---|---|
| Repository Corticotropin Injections | Apr 1, 2026 | Covered |
| Policy | Effective | Status of J0801 |
|---|---|---|
| Repository Corticotropin Injections | Apr 1, 2026 | Covered |
| Policy | Effective | Status of J0801 |
|---|---|---|
| Repository Corticotropin Injections | Apr 1, 2026 | Covered |