34 commercial payer policies list J1747. 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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34 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 J1747 |
|---|---|---|
| Provider Administered Drugs – Site of Care | Jul 1, 2026 | Covered |
| Spevigo (Spesolimab-Sbzo) | Jun 1, 2026 | Covered |
| Spevigo (Spesolimab-Sbzo) – IV and Subcutaneous Formulations (for UHCWest Only) | Jun 1, 2026 | Covered |
| Spevigo (Spesolimab-Sbzo) – Commercial and Individual Exchange Medical Benefit Drug Policy | Not recorded | Covered with conditionsInferred from policy title |
| Spevigo (Spesolimab-Sbzo) – 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 J1747 |
|---|---|---|
| Spesolimab-sbzo (Spevigo)Effective 01/01/2023 - 12/31/2023 | Jan 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Spevigo (spesolimab-sbzo intravenous infusion)Effective 01/01/2024 - 01/31/2025 | Jan 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Spevigo (spesolimab-sbzo) Intravenous Injection | Jan 1, 2026 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Spevigo Intravenous (spesolimab-sbzo intravenous infusion)Effective 02/01/2025 - 12/31/2025 | Feb 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 J1747 |
|---|---|---|
| Spevigo (spesolimab-sbzo) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Spevigo (spesolimab-sbzo) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Spevigo spesolimab-sbzo) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Spevigo spesolimab-sbzo) | 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 J1747 |
|---|---|---|
| Spesolimab-sbzo (Spevigo) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Spesolimab-sbzo (Spevigo) | 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 J1747 |
|---|---|---|
| Spesolimab-sbzo (Spevigo) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Spesolimab-sbzo (Spevigo) | 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 J1747 |
|---|---|---|
| Spevigo (spesolimab) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Spevigo (spesolimab) SQ | 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 J1747 |
|---|---|---|
| Provider Administered Drugs – Site of Care | Jul 1, 2026 | Covered |
| Spevigo (Spesolimab-Sbzo) | Jun 1, 2026 | Covered |
| Policy | Effective | Status of J1747 |
|---|---|---|
| Spesolimab-sbzo (e.g., Spevigo) | 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 J1747 |
|---|---|---|
| Spesolimab-sbzo | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1747 |
|---|---|---|
| Spesolimab-sbzo | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1747 |
|---|---|---|
| Spesolimab-sbzo | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1747 |
|---|---|---|
| Spesolimab-sbzo | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1747 |
|---|---|---|
| SPEVIGO | 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 J1747 |
|---|---|---|
| SPEVIGO (SPESOLIMAB-SBZO) | 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 J1747 |
|---|---|---|
| Spesolimab-sbzo (Spevigo) | Dec 31, 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 J1747 |
|---|---|---|
| Spesolimab-sbzo (Spevigo); CP.PHAR.606 | 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 J1747 |
|---|---|---|
| Spesolimab-sbzo (Spevigo) | 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 J1747 |
|---|---|---|
| 00885 spesolimab-sbzo (Spevigo) | 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 J1747 |
|---|---|---|
| Spevigo (spesolimab-sbzo) (CG071, Ver. 5) | 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 J1747 |
|---|---|---|
| Spevigo (Spesolimab-Sbzo) | Jun 1, 2026 | Covered |