J1325 coverage policies: Medicare and commercial | Backwork

J1325 coverage policies: Medicare and commercial payers

1 active Medicare policy lists J1325, and 12 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.

Get free alerts for J1325

Free account. Policy pages stay open to everyone.

Medicare policies listing J1325

LCD · L33794

External Infusion Pumps

National · Effective Jan 25, 2026

Commercial payer policies listing J1325

12 policies from 4 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.

EviCore by Evernorth

EviCore by Evernorth policies listing J1325, with the code’s status in each
Policy	Effective	Status of J1325
Epoprostenol (Flolan, Veletri)Effective 01/01/2019 - 06/30/2019PayerPolicy · EVICORE-MEDICAL_DRUG-269E63DAD41F	Jan 1, 2019	Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.
Epoprostenol (Flolan, Veletri)Effective 04/01/2022 - 03/31/2023PayerPolicy · EVICORE-MEDICAL_DRUG-107F3FD29A94	Apr 1, 2022	Prior auth requiredInferred from policy title

Epoprostenol (Flolan, Veletri)Effective 04/01/2023 - 02/29/2024PayerPolicy · EVICORE-MEDICAL_DRUG-4471008DD1FA	Apr 1, 2023	Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.

Epoprostenol (Flolan, Veletri)Effective 05/01/2021 - 03/31/2022PayerPolicy · EVICORE-MEDICAL_DRUG-A71BFE2059F6	May 1, 2021	Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.

Epoprostenol (Flolan, Veletri)Effective 06/01/2020 - 04/30/2021PayerPolicy · EVICORE-MEDICAL_DRUG-84290FF84D91	Jun 1, 2020	Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.

Epoprostenol (Flolan, Veletri)Effective 07/01/2019 - 05/31/2020PayerPolicy · EVICORE-MEDICAL_DRUG-0F6B4620FF9B	Jul 1, 2019	Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.

Epoprostenol Injection (Flolan, Veletri, generic)PayerPolicy · EVICORE-MEDICAL_DRUG-5C0D22C1159F	Not recorded	Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.

Epoprostenol Injection (Flolan, Veletri, generic)Effective 03/01/2025 - 02/28/2026PayerPolicy · EVICORE-MEDICAL_DRUG-7B4ED4DB97E4	Mar 1, 2025	Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.

Flolan, Veletri (epoprostenol) injectionEffective 03/01/2024 - 02/28/2025PayerPolicy · EVICORE-MEDICAL_DRUG-E22008C56D34	Mar 1, 2024	Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.

Aetna

Aetna policies listing J1325, with the code’s status in each
Policy	Effective	Status of J1325
Pulmonary Hypertension Treatments and Selected Indications of ProstanoidsPayerPolicy · AETNA-CPB-0184	Aug 30, 2023	Covered

BlueCross BlueShield of Tennessee

BlueCross BlueShield of Tennessee policies listing J1325, with the code’s status in each
Policy	Effective	Status of J1325
Epoprostenol for Continuous Intravenous Infusion (Flolan/Veletri)PayerPolicy · BCBSTN-74d6172da5	May 7, 2018	Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.

Health Net Oregon

Health Net Oregon policies listing J1325, with the code’s status in each
Policy	Effective	Status of J1325
Epoprostenol (Flolan, Veletri); CP.PHAR.192PayerPolicy · HEALTHNET_OR-CP-PHAR-192	Not recorded	Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.