37 commercial payer policies list J1305. 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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37 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 J1305 |
|---|---|---|
| Evinacumab-dgnb (Evkeeza)Effective 04/01/2023 - 08/31/2023 | Apr 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Evinacumab-dgnb (Evkeeza)Effective 05/01/2022 - 03/31/2023 | May 1, 2022 | Prior auth requiredInferred from policy title |
| Evinacumab-dgnb (Evkeeza)Effective 06/01/2021 - 04/30/2022 | Jun 1, 2021 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Evkeeza (evinacumab-dgnb) | Not recorded | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Evkeeza (evinacumab-dgnb)Effective 02/01/2026 - 08/31/2026 | Feb 1, 2026 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Evkeeza (evinacumab-dgnb)Effective 09/01/2023 - 08/31/2024 | Sep 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Evkeeza (evinacumab-dgnb)Effective 09/01/2024 - 08/31/2025 | Sep 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Evkeeza (evinacumab-dgnb)Effective 09/01/2025 - 01/31/2026 | Sep 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 J1305 |
|---|---|---|
| Evkeeza (Evinacumab-Dgnb) | Apr 1, 2026 | Covered |
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| Evkeeza (Evinacumab-Dgnb) – 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. |
| Evkeeza (Evinacumab-Dgnb) – 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. |
| Policy | Effective | Status of J1305 |
|---|---|---|
| Evinacumab-dgnb (Evkeeza) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Evinacumab-dgnb (Evkeeza) | 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 J1305 |
|---|---|---|
| Evinacumab-dgnb | Aug 15, 2025 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1305 |
|---|---|---|
| Evinacumab-dgnb | Aug 15, 2025 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1305 |
|---|---|---|
| Evinacumab-dgnb | Aug 15, 2025 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1305 |
|---|---|---|
| Evinacumab-dgnb | Aug 15, 2025 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1305 |
|---|---|---|
| Evinacumab-dgnb (Evkeeza) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Evinacumab-dgnb (Evkeeza) | 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 J1305 |
|---|---|---|
| Evkeeza (Evinacumab-Dgnb) | Apr 1, 2026 | Covered |
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| Policy | Effective | Status of J1305 |
|---|---|---|
| Evinacumab-dgnb (e.g., Evkeeza) | 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 J1305 |
|---|---|---|
| EVKEEZA (EVINACUMAB) | 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 J1305 |
|---|---|---|
| EVKEEZA (EVINACUMAB) | 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 J1305 |
|---|---|---|
| Evinacumab Dgnb Evkeeza | 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 J1305 |
|---|---|---|
| Evinacumab-dgnb (Evkeeza) | Jun 2, 2021 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J1305 |
|---|---|---|
| Evinacumab-dgnb (Evkeeza); CP.PHAR.511 | 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 J1305 |
|---|---|---|
| Evinacumab-dgnb (Evkeeza) | 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 J1305 |
|---|---|---|
| 00751 evinacumab-dgnb (Evkeeza) | 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 J1305 |
|---|---|---|
| Evkeeza (evinacumab-dgnb) | 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 J1305 |
|---|---|---|
| Evkeeza (evinacumab-dgnb) | 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 J1305 |
|---|---|---|
| Evkeeza (Evinacumab-Dgnb) | Apr 1, 2026 | Covered |