38 commercial payer policies list J3245. 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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38 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 J3245 |
|---|---|---|
| Ilumya (tildrakizumab-asmn) | Not recorded | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Ilumya (tildrakizumab-asmn)Effective 07/01/2024 - 06/30/2025 | Jul 1, 2024 | Prior auth requiredInferred from policy title |
| Ilumya (tildrakizumab-asmn)Effective 07/01/2025 - 06/30/2026 | Jul 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Tildrakizumab-Asmn (Ilumya)Effective 07/01/2023 - 06/30/2024 | Jul 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Tildrakizumab-Asmn (Ilumya)Effective 08/01/2021 - 07/31/2022 | Aug 1, 2021 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Tildrakizumab-Asmn (Ilumya)Effective 08/01/2022 - 06/30/2023 | Aug 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Tildrakizumab-Asmn (Ilumya)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. |
|---|
| Tildrakizumab-Asmn (Ilumya)Effective 10/01/2019 - 08/30/2020 | Oct 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Tildrakizumab-Asmn (Ilumya)Effective 11/02/2018 - 09/30/2019 | Nov 2, 2018 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Policy | Effective | Status of J3245 |
|---|---|---|
| Ilumya (Tildrakizumab-Asmn) | Jun 1, 2026 | Covered |
| Provider Administered Drugs – Site of Care | Jul 1, 2026 | Covered |
| Ilumya (Tildrakizumab-Asmn) – 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. |
| Ilumya (Tildrakizumab-Asmn) – 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 J3245 |
|---|---|---|
| Tildrakizumab-asmn (Ilumya) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Tildrakizumab-asmn (Ilumya) | 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 J3245 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Tildrakizumab-asmn | Aug 15, 2025 | Covered |
| Policy | Effective | Status of J3245 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Tildrakizumab-asmn | Aug 15, 2025 | Covered |
| Policy | Effective | Status of J3245 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Tildrakizumab-asmn | Aug 15, 2025 | Covered |
| Policy | Effective | Status of J3245 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Tildrakizumab-asmn | Aug 15, 2025 | Covered |
| Policy | Effective | Status of J3245 |
|---|---|---|
| ILUMYA (TILDRAKIZUMAB-ASMN) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| NON AIM MEDICAL POLICY - TILDRAKIZUMAB-ASMN: ILUMYA (J3245) | 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 J3245 |
|---|---|---|
| Tildrakizumab-asmn (Ilumya) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Tildrakizumab-asmn (Ilumya) | 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 J3245 |
|---|---|---|
| Ilumya (Tildrakizumab-Asmn) | Jun 1, 2026 | Covered |
| Provider Administered Drugs – Site of Care | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J3245 |
|---|---|---|
| Tildrakizumab-asmn (e.g., Ilumya) | 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 J3245 |
|---|---|---|
| Tildrakizumab Asmn Ilumya | 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 J3245 |
|---|---|---|
| Tildrakizumab-asmn (Ilumya) | Apr 30, 2018 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J3245 |
|---|---|---|
| Ilumya (tildrakizumab-asmn) | 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 J3245 |
|---|---|---|
| Tildrakizumab (Ilumya) | 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 J3245 |
|---|---|---|
| 00651 tildrakizumab-asmn (Ilumya) | 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 J3245 |
|---|---|---|
| Ilumya (tildrakizumab-asmn) | 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 J3245 |
|---|---|---|
| Ilumya (tildrakizumab-asmn) (CG053, Ver. 9) | 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 J3245 |
|---|---|---|
| Ilumya (Tildrakizumab-Asmn) | Jun 1, 2026 | Covered |