Dexamethasone Intracanalicular Ophthalmic Insert (Dextenza)
National · Effective May 26, 2022
2 active Medicare policies list J1096, and 9 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 May 26, 2022
National · Effective Dec 24, 2020
9 policies from 9 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 J1096 |
|---|---|---|
| Intravitreal, Punctum Corticosteroid Implants (e.g., Retisert, Yutiq, Iluvien, Ozurdex, and Dextenza) | 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 J1096 |
|---|
| Intravitreal, Punctum, and Intracameral Implants | Jan 1, 2026 | Covered |
|---|
| Policy | Effective | Status of J1096 |
|---|---|---|
| Intravitreal, Punctum, and Intracameral Implants | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1096 |
|---|---|---|
| Intravitreal, Punctum, and Intracameral Implants | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1096 |
|---|---|---|
| Intravitreal, Punctum, and Intracameral Implants | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1096 |
|---|---|---|
| Corticosteroids for ophthalmic injection (Dextenza, Iluvien, Ozurdex, Retisert, Xipere, Yutiq); CP.PHAR.385 | 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 J1096 |
|---|---|---|
| Intracanalicular and Intravitreal Corticosteroid Implants | Nov 1, 2025 | Covered |
| Policy | Effective | Status of J1096 |
|---|---|---|
| Intracanalicular and Intravitreal Corticosteroid Implants | Nov 1, 2025 | Covered |
| Policy | Effective | Status of J1096 |
|---|---|---|
| Intracanalicular and Intravitreal Corticosteroid Implants | Nov 1, 2025 | Covered |