41 commercial payer policies list J2507. 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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41 policies from 24 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 J2507 |
|---|---|---|
| Krystexxa (pegloticase) | Jan 1, 2026 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Krystexxa (pegloticase)Effective 01/01/2025 - 12/31/2025 | Jan 1, 2025 | Prior auth requiredInferred from policy title |
| Krystexxa (pegloticase)Effective 03/01/2024 - 12/31/2024 | Mar 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Pegloticase (Krystexxa)Effective 01/01/2019 - 05/31/2019 | Jan 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Pegloticase (Krystexxa)Effective 03/01/2022 - 02/28/2023 | Mar 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Pegloticase (Krystexxa)Effective 03/01/2023 - 02/29/2024 | Mar 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Pegloticase (Krystexxa)Effective 04/01/2021 - 02/28/2022 | Apr 1, 2021 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Pegloticase (Krystexxa)Effective 05/01/2020 - 03/31/2021 | May 1, 2020 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
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| Pegloticase (Krystexxa)Effective 06/01/2019 - 04/30/2020 | Jun 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Policy | Effective | Status of J2507 |
|---|---|---|
| Krystexxa (Pegloticase) | Nov 1, 2025 | Covered |
| Krystexxa (Pegloticase) – 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. |
| Krystexxa (Pegloticase) – 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 J2507 |
|---|---|---|
| Pegloticase (Krystexxa) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Pegloticase (Krystexxa) | 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 J2507 |
|---|---|---|
| Pegloticase | Jan 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J2507 |
|---|---|---|
| Pegloticase | Jan 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J2507 |
|---|---|---|
| Pegloticase | Jan 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J2507 |
|---|---|---|
| Pegloticase | Jan 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J2507 |
|---|---|---|
| Krystexxa (pegloticase) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| State and School Employees' Health Insurance Plan - Krystexxa (pegloticase) | 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 J2507 |
|---|---|---|
| Pegloticase (Krystexxa) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Pegloticase (Krystexxa) | 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 J2507 |
|---|---|---|
| Pegloticase (e.g., Krystexxa) | 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 J2507 |
|---|---|---|
| KRYSTEXXA/ PEGLOTICASE | 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 J2507 |
|---|---|---|
| KRYSTEXXA (PEGLOTICASE) | 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 J2507 |
|---|---|---|
| Pegloticase Krystexxa | 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 J2507 |
|---|---|---|
| Krystexxa. Medical Policy 5.01.665 Krystexxa DISCLAIMER/INSTRUCTIONS FOR USE This medical policy provides general guidance for applying Blue Cross of Idaho benefit plans (for purposes of this | 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 J2507 |
|---|---|---|
| Pegloticase (Krystexxa) | Oct 11, 2011 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J2507 |
|---|---|---|
| Pegloticase (Krystexxa) | 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 J2507 |
|---|---|---|
| Pegloticase (Krystexxa); CP.PHAR.115 | 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 J2507 |
|---|---|---|
| Pegloticase (Krystexxa) | 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 J2507 |
|---|---|---|
| Pegloticase (Krystexxa) | 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 J2507 |
|---|---|---|
| 00290 pegloticase (Krystexxa) | 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 J2507 |
|---|---|---|
| Krystexxa (pegloticase) | 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 J2507 |
|---|---|---|
| Krystexxa (pegloticase) | 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 J2507 |
|---|---|---|
| Krystexxa (Pegloticase) | Nov 1, 2025 | Covered |
| Policy | Effective | Status of J2507 |
|---|---|---|
| Krystexxa (Pegloticase) | Nov 1, 2025 | Covered |