42 commercial payer policies list J1823. 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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42 policies from 23 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 J1823 |
|---|---|---|
| Inebilizumab-cdon (Uplizna) InjectionEffective 01/01/2023 - 12/31/2024 | Jan 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Inebilizumab-cdon (Uplizna) InjectionEffective 02/01/2022 - 12/31/2022 | Feb 1, 2022 | Prior auth requiredInferred from policy title |
| Inebilizumab-cdon (Uplizna) InjectionEffective 10/01/2021 - 01/31/2022 | Oct 1, 2021 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Inebilizumab-cdon (Uplizna)Effective 11/01/2020 - 09/30/2021 | Nov 1, 2020 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Uplizna (inebilizumab-cdon) Injection | Not recorded | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Uplizna (inebilizumab-cdon) injectionEffective 01/01/2024 - 12/31/2024 | Jan 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Uplizna (inebilizumab-cdon) injectionEffective 01/01/2025 - 09/30/2025 | Jan 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Uplizna (inebilizumab-cdon) InjectionEffective 10/01/2025 - 06/30/2026 | Oct 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 J1823 |
|---|---|---|
| Provider Administered Drugs – Site of Care | Jul 1, 2026 | Covered |
| Uplizna (Inebilizumab-Cdon) | Apr 1, 2026 | Covered |
| Uplizna (Inebilizumab-Cdon) – 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. |
| Uplizna (Inebilizumab-Cdon) – 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 J1823 |
|---|---|---|
| Inebilizumab-cdon (Uplizna) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Inebilizumab-cdon (Uplizna) | 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 J1823 |
|---|---|---|
| Inebilizumab-cdon | May 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1823 |
|---|---|---|
| Inebilizumab-cdon | May 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1823 |
|---|---|---|
| Inebilizumab-cdon | May 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1823 |
|---|---|---|
| Inebilizumab-cdon | May 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J1823 |
|---|---|---|
| State and School Employees' Health Insurance Plan - Uplizna (inebilizumab-cdon) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Uplizna (inebilizumab-cdon) | 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 J1823 |
|---|---|---|
| Inebilizumab-cdon (Uplizna) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Inebilizumab-cdon (Uplizna) | 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 J1823 |
|---|---|---|
| Uplizna (inebilizumab-cdon) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Uplizna (inebilizumab-cdon) | 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 J1823 |
|---|---|---|
| Provider Administered Drugs – Site of Care | Jul 1, 2026 | Covered |
| Uplizna (Inebilizumab-Cdon) | Apr 1, 2026 | Covered |
| Policy | Effective | Status of J1823 |
|---|---|---|
| Inebilizumab-cdon (e.g., Uplizna) | 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 J1823 |
|---|---|---|
| ULTOMIRIS, PIASKY, UPLIZNA, EMPAVELI, PIASKY,RYSTIGGO, IMAAVY | 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 J1823 |
|---|---|---|
| UPLIZNA (INEBILIZUMAB) | 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 J1823 |
|---|---|---|
| Inebilizumab Cdon Uplizna | 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 J1823 |
|---|---|---|
| Inebilizumab-cdon (Uplizna) | Sep 1, 2020 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J1823 |
|---|---|---|
| Uplizna (inebilizumab-cdon) | 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 J1823 |
|---|---|---|
| Satralizumab-mwge (Enspryng) and inebilizumab-cdon (Uplizna) | 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 J1823 |
|---|---|---|
| Enspryng (satralizumab-mwge) and Uplizna (inebilizumab-cdon) | 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 J1823 |
|---|---|---|
| Inebilizumab-cdon (Uplizna) | 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 J1823 |
|---|---|---|
| 00736 satralizumab-mwge (Enspryng), inebilizumab-cdon (Uplizna) | 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 J1823 |
|---|---|---|
| Uplizna (inebilizumab-cdon) | 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 J1823 |
|---|---|---|
| Uplizna (Inebilizumab-Cdon) | Apr 1, 2026 | Covered |