41 commercial payer policies list J3111. 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.
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 J3111 |
|---|---|---|
| Evenity (romosozumab-aqqg) | Not recorded | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Evenity (romosozumab-aqqg)Effective 06/01/2024 - 05/31/2025 | Jun 1, 2024 | Prior auth requiredInferred from policy title |
| Evenity (romosozumab-aqqg)Effective 06/01/2025 - 05/31/2026 | Jun 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Romosozumab-aqqg (Evenity)Effective 07/01/2022 - 06/30/2023 | Jul 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Romosozumab-aqqg (Evenity)Effective 07/01/2023 - 05/31/2024 | Jul 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Romosozumab-aqqg (Evenity)Effective 08/01/2019 - 08/30/2020 | Aug 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Romosozumab-aqqg (Evenity)Effective 08/01/2021 - 06/30/2022 | Aug 1, 2021 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Romosozumab-aqqg (Evenity)Effective 09/01/2020 - 07/31/2021 | Sep 1, 2020 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Policy | Effective | Status of J3111 |
|---|---|---|
| Evenity (Romosozumab-Aqqg) | Dec 1, 2025 | Covered |
| Evenity (Romosozumab-Aqqg) – 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. |
| Evenity (Romosozumab-Aqqg) – 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 J3111 |
|---|---|---|
| Denosumab (Prolia, Xgeva) and related biosimilars, and Romosozumab-aqqg (Evenity) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Denosumab (Prolia, Xgeva) and related biosimilars, and Romosozumab-aqqg (Evenity) | 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 J3111 |
|---|---|---|
| Romosozumab-aqqg | Aug 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J3111 |
|---|---|---|
| Romosozumab-aqqg | Aug 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J3111 |
|---|---|---|
| Romosozumab-aqqg | Aug 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J3111 |
|---|---|---|
| Romosozumab-aqqg | Aug 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J3111 |
|---|---|---|
| Evenity (romosozumab-aqqg) | 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 - Evenity (romosozumab-aqqg) | 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 J3111 |
|---|---|---|
| Denosumab (Prolia, Xgeva) and related biosimilars, and Romosozumab-aqqg (Evenity) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Denosumab (Prolia, Xgeva) and related biosimilars, and Romosozumab-aqqg (Evenity) | 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 J3111 |
|---|---|---|
| Evenity (romosozumab-aqqg) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Evenity (romosozumab-aqqg) | 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 J3111 |
|---|---|---|
| Romosozumab-aqqg (e.g., Evenity) | 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 J3111 |
|---|---|---|
| EVENITY | 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 J3111 |
|---|---|---|
| EVENITY (ROMOSOZUMAB) | 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 J3111 |
|---|---|---|
| Romosozumab Aqqg Evenity | 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 J3111 |
|---|---|---|
| Evenity (romosozumab-aqqg). Medical Policy MP 5.01.675 Evenity (romosozumab-aqqg) DISCLAIMER/INSTRUCTIONS FOR USE This medical policy provides general guidance for applying Blue Cross of Idaho | 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 J3111 |
|---|---|---|
| Romosozumab-aqqg (Evenity) | Sep 30, 2019 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J3111 |
|---|---|---|
| Evenity (romosozumab-aqqg) | 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 J3111 |
|---|---|---|
| Romosozumab-aqqg (Evenity); CP.PHAR.428 | 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 J3111 |
|---|---|---|
| Romosozumab-aqqg (Evenity) | 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 J3111 |
|---|---|---|
| Romosozumab-aqqg (Evenity) | 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 J3111 |
|---|---|---|
| 00686 romosozumab aqqg (Evenity) | 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 J3111 |
|---|---|---|
| Evenity (romosozumab-aqqg) | 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 J3111 |
|---|---|---|
| Evenity (Romosozumab-Aqqg) | Dec 1, 2025 | Covered |
| Policy | Effective | Status of J3111 |
|---|---|---|
| Evenity (Romosozumab-Aqqg) | Dec 1, 2025 | Covered |