31 commercial payer policies list J1746. 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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31 policies from 16 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 J1746 |
|---|---|---|
| Ibalizumab-uiyk (Trogarzo)Effective 02/01/2020 - 11/30/2020 | Feb 1, 2020 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Ibalizumab-uiyk (Trogarzo)Effective 06/01/2022 - 05/31/2023 | Jun 1, 2022 | Prior auth requiredInferred from policy title |
| Ibalizumab-uiyk (Trogarzo)Effective 06/01/2023 - 04/30/2024 | Jun 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Ibalizumab-uiyk (Trogarzo)Effective 08/01/2018 - 01/31/2020 | Aug 1, 2018 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Ibalizumab-uiyk (Trogarzo)Effective 11/01/2021 - 05/31/2022 | Nov 1, 2021 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Ibalizumab-uiyk (Trogarzo)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. |
|---|
| Trogarzo (ibalizumab-uiyk injection) | Not recorded | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Trogarzo (ibalizumab-uiyk injection)Effective 05/01/2024 - 04/30/2025 | May 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Trogarzo (ibalizumab-uiyk injection)Effective 05/01/2025 - 04/30/2026 | May 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 J1746 |
|---|---|---|
| Trogarzo (Ibalizumab-Uiyk) | Jun 1, 2026 | Covered |
| Trogarzo (Ibalizumab-Uiyk) – 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. |
| Trogarzo (Ibalizumab-Uiyk) – 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 J1746 |
|---|---|---|
| Ibalizumab-uiyk | Apr 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1746 |
|---|---|---|
| Ibalizumab-uiyk | Apr 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1746 |
|---|---|---|
| Ibalizumab-uiyk | Apr 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1746 |
|---|---|---|
| Ibalizumab-uiyk | Apr 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1746 |
|---|---|---|
| Ibalizumab-uiyk (Trogarzo) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Ibalizumab-uiyk (Trogarzo) – Minnesota Health Care Programs | 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 J1746 |
|---|---|---|
| TROGARZO | 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 J1746 |
|---|---|---|
| TROGARZO (IBALIZUMAB-ULYK) | 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 J1746 |
|---|---|---|
| Ibalizumab Uiyk Trogarzo | 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 J1746 |
|---|---|---|
| Ibalizumab-uiyk (Trogarzo) | Apr 16, 2018 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J1746 |
|---|---|---|
| Ibalizumab-uiyk (Trogarzo); CP. PHAR.378 | 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 J1746 |
|---|---|---|
| Ibalizumab-uiyk (Trogarzo) | 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 J1746 |
|---|---|---|
| Trogarzo (ibalizumab-uiyk) | 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 J1746 |
|---|---|---|
| Trogarzo (Ibalizumab-Uiyk) | Jun 1, 2026 | Covered |
| Policy | Effective | Status of J1746 |
|---|---|---|
| Trogarzo (Ibalizumab-Uiyk) | Jun 1, 2026 | Covered |