White Cell Colony Stimulating Factors
JJ · Effective Jun 12, 2017
6 active Medicare policies list J2506, and 18 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.
Free account. Policy pages stay open to everyone.
JJ · Effective Jun 12, 2017
JM · Effective Jun 12, 2017
National · Effective Jan 1, 2024
National · Effective Oct 1, 2025
National · Effective Mar 14, 2024
J6 · Effective Feb 1, 2024
18 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 J2506 |
|---|---|---|
| Efbemalenograstim alfa-vuxw (Ryzneuta), Eflapegrastim-xnst (Rolvedon), Pegfilgrastim (Neulasta) and Related Biosimilars | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Efbemalenograstim alfa-vuxw (Ryzneuta), Eflapegrastim-xnst (Rolvedon), Pegfilgrastim (Neulasta) and Related Biosimilars | Not recorded | Covered with conditionsInferred from policy title |
| Policy | Effective | Status of J2506 |
|---|---|---|
| Efbemalenograstim alfa-vuxw (Ryzneuta), Eflapegrastim-xnst (Rolvedon), Pegfilgrastim (Neulasta) and Related Biosimilars | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Efbemalenograstim alfa-vuxw (Ryzneuta), Eflapegrastim-xnst (Rolvedon), Pegfilgrastim (Neulasta) and Related Biosimilars | 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 J2506 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J2506 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J2506 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J2506 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J2506 |
|---|---|---|
| Pegfilgrastim (Neulasta); Pegfilgrastim-jmdb (Fulphila); Pegfilgrastim--pbbk (Fylnetra); Pegfilgrastim- apgf (Nyvepria); Pegfilgrastim-fpgk (Stimufed); Pegfilgrastim-cbqv (Udenyca); Pegfilgrastim-bmez (Ziextenzo) | Dec 1, 2016 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J2506 |
|---|---|---|
| Cigna MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J2506 |
|---|---|---|
| Pegfilgrastim injection (Neulasta)Effective 12/15/2017 - 12/15/2017 | Dec 15, 2017 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J2506 |
|---|---|---|
| Pegfilgrastim (Neulasta and biosimilars); CP.PHAR.296 | 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 J2506 |
|---|---|---|
| Q3 - 2026 Jefferson Health Plans MedOnc Master Drug List | Not recorded | Prior auth required |
| Policy | Effective | Status of J2506 |
|---|---|---|
| Granulocyte Colony Stimulating Factor (G-CSF - Neupogen, Neulasta, Granix, Zarxio, Fulphila, Nivestym, Udenyca, Ziextenzo, Nyvepria) and Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF - Leukine) | 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 J2506 |
|---|---|---|
| Long-Acting Granulocyte Colony Stimulating Factors (LA-GCSF): Fulphila; Fylnetra; Neulasta; Nyvepria; Pegfilgrastimfpgk; Rolvedon; Ryzneuta; Stimufend; Udenyca; Ziextenzo | 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 J2506 |
|---|---|---|
| White Blood Cell Colony Stimulating Factors | Sep 1, 2026 | Covered |
| Policy | Effective | Status of J2506 |
|---|---|---|
| White Blood Cell Colony Stimulating Factors | Sep 1, 2026 | Covered |
| Policy | Effective | Status of J2506 |
|---|---|---|
| White Blood Cell Colony Stimulating Factors | Sep 1, 2026 | Covered |