36 commercial payer policies list J2356. 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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36 policies from 19 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 J2356 |
|---|---|---|
| Tezepelumab-ekko (Tezspire)Effective 05/01/2022 - 04/30/2023 | May 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Tezepelumab-ekko (Tezspire)Effective 05/01/2023 - 03/31/2024 | May 1, 2023 | Prior auth requiredInferred from policy title |
| Tezspire (tezepelumab-ekko) | Not recorded | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Tezspire (tezepelumab-ekko)Effective 04/01/2024 - 03/31/2025 | Apr 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Tezspire (tezepelumab-ekko)Effective 04/01/2025 - 03/31/2026 | Not recorded | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Policy | Effective | Status of J2356 |
|---|---|---|
| Tezspire (tezepelumab-ekko) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Tezspire (tezepelumab-ekko) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Tezspire (tezepelumab-ekko) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Tezspire (tezepelumab-ekko) pre-filled pen | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Tezspire (tezepelumab-ekko) Pre-filled Pen | 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 J2356 |
|---|---|---|
| Provider Administered Drugs – Site of Care | Jul 1, 2026 | Covered |
| Tezspire (Tezepelumab-Ekko) | Feb 1, 2026 | Covered |
| Tezspire (Tezepelumab-Ekko) – 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. |
| Tezspire (Tezepelumab-Ekko) – 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 J2356 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Tezepelumab-ekko | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J2356 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Tezepelumab-ekko | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J2356 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Tezepelumab-ekko | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J2356 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Tezepelumab-ekko | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J2356 |
|---|---|---|
| State and School Employees' Health Insurance Plan - Tezspire (tezepelumab-ekko) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Tezspire (tezepelumab-ekko) | 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 J2356 |
|---|---|---|
| Provider Administered Drugs – Site of Care | Jul 1, 2026 | Covered |
| Tezspire (Tezepelumab-Ekko) | Feb 1, 2026 | Covered |
| Policy | Effective | Status of J2356 |
|---|---|---|
| Tezepelumab-ekko (Tezspire) | 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 J2356 |
|---|---|---|
| TEZSPIRE (TEZEPELUMAB-EKKO) | 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 J2356 |
|---|---|---|
| Tezepelumab-ekko (Tezspire) | Apr 2, 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 J2356 |
|---|---|---|
| Tezspire (Tezepelumab) | 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 J2356 |
|---|---|---|
| Tezepelumab-ekko (Tezspire); CP.PHAR.576 | 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 J2356 |
|---|---|---|
| Tezepelumab-ekko (Tezspire) | 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 J2356 |
|---|---|---|
| 00788 tezepelumab-ekko (Tezspire) | 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 J2356 |
|---|---|---|
| Tezspire (tezepelumab-ekko) | 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 J2356 |
|---|---|---|
| Tezspire (tezepelumab) (PG118, Ver. 7) | 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 J2356 |
|---|---|---|
| Tezspire (Tezepelumab-Ekko) | Feb 1, 2026 | Covered |