39 commercial payer policies list J1302. 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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39 policies from 20 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 J1302 |
|---|---|---|
| Enjaymo (sutimlimab-jome) | Nov 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Enjaymo (sutimlimab-jome)Effective 11/01/2023 - 10/31/2024 | Nov 1, 2023 | Prior auth requiredInferred from policy title |
| Enjaymo (sutimlimab-jome)Effective 11/01/2024 - 10/31/2025 | Nov 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Sutimlimab-jome (Enjaymo)Effective 07/01/2022 - 10/31/2022 | Jul 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Sutimlimab-jome (Enjaymo)Effective 11/01/2022 - 10/31/2023 | Nov 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Policy | Effective | Status of J1302 |
|---|---|---|
| Enjaymo (Sutimlimab-Jome) | Apr 1, 2026 | Covered |
| Provider Administered Drugs – Site of Care | Jul 1, 2026 | Covered |
| Enjaymo (Sutimlimab-Jome) – 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. |
| Enjaymo (Sutimlimab-Jome) – 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 J1302 |
|---|---|---|
| Inside the U.S. Food and Drug Administration (FDA) | Jan 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Sutimlimab-jome | Aug 15, 2026 | Covered |
| Policy | Effective | Status of J1302 |
|---|---|---|
| Inside the U.S. Food and Drug Administration (FDA) | Jan 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Sutimlimab-jome | Aug 15, 2026 | Covered |
| Policy | Effective | Status of J1302 |
|---|---|---|
| Inside the U.S. Food and Drug Administration (FDA) | Jan 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Sutimlimab-jome | Aug 15, 2026 | Covered |
| Policy | Effective | Status of J1302 |
|---|---|---|
| Inside the U.S. Food and Drug Administration (FDA) | Jan 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Sutimlimab-jome | Aug 15, 2026 | Covered |
| Policy | Effective | Status of J1302 |
|---|---|---|
| Sutimlimab-jome (Enjaymo) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Sutimlimab-jome (Enjaymo) | 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 J1302 |
|---|---|---|
| Enjaymo (sutimlimab-jome) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| State and School Employees' Health Insurance Plan - Enjaymo (sutimlimab-jome) | 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 J1302 |
|---|---|---|
| Sutimlimab-jome (Enjaymo) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Sutimlimab-jome (Enjaymo) | 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 J1302 |
|---|---|---|
| Enjaymo (Sutimlimab-Jome) | Apr 1, 2026 | Covered |
| Provider Administered Drugs – Site of Care | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J1302 |
|---|---|---|
| Sutimlimab-jome (e.g., Enjaymo) | 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 J1302 |
|---|---|---|
| ENJAYMO | 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 J1302 |
|---|---|---|
| ENJAYMO (SUTIMLIMAB INTRAVENOUS 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 J1302 |
|---|---|---|
| Sutimlimab-jome (Enjaymo) | Apr 30, 2022 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J1302 |
|---|---|---|
| Sutimlimab-jome (Enjaymo); CP.PHAR.503 | 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 J1302 |
|---|---|---|
| Sutimlimab-jome (Enjaymo) | 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 J1302 |
|---|---|---|
| 00800 sutimlimab-jome (Enjaymo) | 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 J1302 |
|---|---|---|
| Enjaymo (sutimlimab-jome) | 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 J1302 |
|---|---|---|
| Enjaymo (sutimlimab-jome) | 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 J1302 |
|---|---|---|
| Enjaymo (Sutimlimab-Jome) | Apr 1, 2026 | Covered |