Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
J6 · Effective Oct 1, 2015
3 active Medicare policies list J2779, and 14 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.
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J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
J6 · Effective Jan 1, 2026
14 policies from 9 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 J2779 |
|---|---|---|
| Ranibizumab Implant (Susvimo)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. |
| Ranibizumab Implant (Susvimo)Effective 03/01/2023 - 01/31/2024 | Mar 1, 2023 | Prior auth requiredInferred from policy title |
| Susvimo (ranibizumab intravitreal injection via ocular implant) | Jan 1, 2026 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Susvimo (ranibizumab intravitreal injection via ocular implant)Effective 02/01/2024 - 11/30/2024 | Feb 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Susvimo (ranibizumab intravitreal injection via ocular implant)Effective 12/01/2024 - 12/31/2025 | 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 J2779 |
|---|---|---|
| Susvimo (Ranibizumab Injection) | Sep 1, 2025 | Covered |
| Susvimo (Ranibizumab Injection) – Commercial and 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 J2779 |
|---|---|---|
| Implanted Port Delivery Systems to Treat Ocular Disease | Apr 16, 2025 | Not covered |
| Policy | Effective | Status of J2779 |
|---|---|---|
| Ranibizumab (e.g., Susvimo) | 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 J2779 |
|---|---|---|
| Ranibizumab (Susvimo) | Dec 31, 2025 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J2779 |
|---|---|---|
| Ranibizumab (Byooviz, Cimerli, Lucentis, Nufymco, Susvimo); CP.PHAR.186 | 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 J2779 |
|---|---|---|
| Susvimo (ranibizumab) | 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 J2779 |
|---|---|---|
| Susvimo (Ranibizumab Injection) | Sep 1, 2025 | Covered |
| Policy | Effective | Status of J2779 |
|---|---|---|
| Susvimo (Ranibizumab Injection) | Sep 1, 2025 | Covered |