19 commercial payer policies list J0870. 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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19 policies from 16 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 J0870 |
|---|---|---|
| Imetelstat (Rytelo) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Imetelstat (Rytelo) | Not recorded | Covered with conditionsInferred from policy title |
| Policy | Effective | Status of J0870 |
|---|---|---|
| Imetelstat (Rytelo) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Imetelstat (Rytelo) | 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 J0870 |
|---|---|---|
| Rytelo (imetelstat) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Rytelo (imetelstat) | 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 J0870 |
|---|---|---|
| Imetelstat (e.g., Rytelo) | 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 J0870 |
|---|---|---|
| Oncology Medications | Oct 1, 2026 | Covered |
| Policy | Effective | Status of J0870 |
|---|---|---|
| Oncology Medications | Oct 1, 2026 | Covered |
| Policy | Effective | Status of J0870 |
|---|---|---|
| Oncology Medications | Oct 1, 2026 | Covered |
| Policy | Effective | Status of J0870 |
|---|---|---|
| Oncology Medications | Oct 1, 2026 | Covered |
| Policy | Effective | Status of J0870 |
|---|---|---|
| RYTELO | 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 J0870 |
|---|---|---|
| Imetelstat (Rytelo) | Oct 1, 2024 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0870 |
|---|---|---|
| Cigna MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J0870 |
|---|---|---|
| Imetelstat (Rytelo); CP.PHAR.690 | 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 J0870 |
|---|---|---|
| Q4 - 2026 JHP MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J0870 |
|---|---|---|
| Oncology - luspatercept-aamt (Reblozyl) and imetelstat (Rytelo) | 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 J0870 |
|---|---|---|
| 00917 imetelstat (Rytelo) | 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 J0870 |
|---|---|---|
| Rytelo (imetelstat) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |