Erythropoiesis Stimulating Agents
J6
11 active Medicare policies list J0888, and 27 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
J6 · Effective Jul 15, 2026
JK
JK · Effective Jul 15, 2026
JJ · Effective Jul 24, 2022
JM · Effective Jul 24, 2022
J5 · Effective Oct 1, 2015
J8 · Effective Oct 1, 2015
National · Effective Oct 1, 2026
National · Effective Jul 15, 2026
27 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 J0888 |
|---|---|---|
| Methoxy Polyethylene Glycol-Epoetin Beta (Mircera) InjectionEffective 10/01/2022 - 09/30/2023 | Oct 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Methoxy Polyethylene Glycol-Epoetin Beta (Mircera) InjectionEffective 11/01/2021 - 09/30/2022 | Nov 1, 2021 | Prior auth requiredInferred from policy title |
J5 · Effective Apr 1, 2025
| Methoxy Polyethylene Glycol-Epoetin Beta (Mircera)Effective 11/01/2019 - 11/30/2020 | Nov 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Methoxy Polyethylene Glycol-Epoetin Beta (Mircera)Effective 12/01/2018 - 10/31/2019 | Dec 1, 2018 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Methoxy Polyethylene Glycol-Epoetin Beta (Mircera)Effective 12/01/2020 - 10/31/2021 | Dec 1, 2020 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
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| Mircera (methoxy polyethylene glycol- epoetin beta)Effective 10/01/2023 - 09/30/2024 | Oct 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
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| Mircera (methoxy polyethylene glycol-epoetin beta) Injection | Oct 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
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| Mircera (methoxy polyethylene glycol-epoetin beta) InjectionEffective 10/01/2026 | Not recorded | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Mircera (methoxy polyethylene glycol-epoetin beta) InjectionEffective 11/01/2024 - 09/30/2025 | Nov 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Mircera(methoxy polyethylene glycol- epoetin beta)Effective 10/01/2024 - 10/31/2024 | Oct 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Policy | Effective | Status of J0888 |
|---|---|---|
| Acute Ischemic Stroke Treatments | Nov 7, 2023 | Covered |
| Erythropoiesis Stimulating Agents | Jan 9, 2024 | Covered |
| Policy | Effective | Status of J0888 |
|---|---|---|
| Erythropoiesis-Stimulating Agents (ESAs) | Jan 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J0888 |
|---|---|---|
| Erythropoiesis-Stimulating Agents (ESAs) | Jan 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J0888 |
|---|---|---|
| Erythropoiesis-Stimulating Agents (ESAs) | Jan 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J0888 |
|---|---|---|
| Erythropoiesis-Stimulating Agents (ESAs) | Jan 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J0888 |
|---|---|---|
| MIRCERA (retired as of 06/10/2021) | 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 J0888 |
|---|---|---|
| Methoxy Polyethylene Glycol-Epoetin Beta (Mircera) | Dec 1, 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 J0888 |
|---|---|---|
| Methoxy polyethylene glycol-epoetin beta (Mircera); CP.PHAR.238 | 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 J0888 |
|---|---|---|
| 00210 Erythropoiesis-Stimulating Agents (ESA’s): epoetin alfa (Epogen and Procrit), epoetin alfa-epbx (Retacrit), darbepoetin alfa (Aranesp), and pegylated epoetin beta (Mircera) | 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 J0888 |
|---|---|---|
| Erythropoiesis-Stimulating Agents | Apr 1, 2026 | Covered |
| Policy | Effective | Status of J0888 |
|---|---|---|
| Erythropoiesis-Stimulating Agents | Apr 1, 2026 | Covered |
| Policy | Effective | Status of J0888 |
|---|---|---|
| Erythropoiesis-Stimulating Agents | Apr 1, 2026 | Covered |