34 commercial payer policies list J3262. 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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34 policies from 15 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 J3262 |
|---|---|---|
| Actemra (tocilizumab)Effective 10/01/2023 - 09/30/2024 | Oct 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Tocilizumab (Actemra)Effective 09/01/2020 - 10/31/2020 | Sep 1, 2020 | Prior auth requiredInferred from policy title |
| Tocilizumab (Actemra)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. |
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| Tocilizumab (Actemra)Effective 10/01/2021 - 09/30/2022 | Oct 1, 2021 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
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| Tocilizumab (Actemra)Effective 10/01/2022 - 09/30/2023 | Oct 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
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| Tocilizumab (Actemra)Effective 11/01/2020 - 09/30/2021 | Nov 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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| Tocilizumab (Actemra)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. |
|---|
| Tocilizumab Intravenous (Actemra, Avtozma, Tyenne, Tofidence) non-oncology | Feb 1, 2026 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
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| Tocilizumab Intravenous (Actemra, Tyenne, Tofidence) non-oncologyEffective 10/01/2025 - 01/31/2026 | Oct 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Tocilizumab Intravenous (Actemra, Tyenne, Tofidence)Effective 10/01/2024 - 02/28/2025 | Oct 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Policy | Effective | Status of J3262 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Tocilizumab and Associated Biosimilar(s) | Apr 1, 2026 | Covered |
| Policy | Effective | Status of J3262 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Tocilizumab and Associated Biosimilar(s) | Apr 1, 2026 | Covered |
| Policy | Effective | Status of J3262 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Tocilizumab and Associated Biosimilar(s) | Apr 1, 2026 | Covered |
| Policy | Effective | Status of J3262 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Tocilizumab and Associated Biosimilar(s) | Apr 1, 2026 | Covered |
| Policy | Effective | Status of J3262 |
|---|---|---|
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| Tocilizumab Injection for Intravenous Infusion | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J3262 |
|---|---|---|
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| Tocilizumab Injection for Intravenous Infusion | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J3262 |
|---|---|---|
| Tocilizumab (e.g., Actemra) and 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 J3262 |
|---|---|---|
| Tocilizumab Actemra | 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 J3262 |
|---|---|---|
| Cigna MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J3262 |
|---|---|---|
| Q3 - 2026 Jefferson Health Plans MedOnc Master Drug List | Not recorded | Prior auth required |
| Policy | Effective | Status of J3262 |
|---|---|---|
| Tocilizumab (Actemra) | 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 J3262 |
|---|---|---|
| Tocilizumab: Actemra; Tofidence; Tyenne; Avtozma; Tocilizumab-anoh§; Tocilizumab-aazg§ | 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 J3262 |
|---|---|---|
| Actemra (tocilizumab) Subcutaneous | 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 J3262 |
|---|---|---|
| Tocilizumab Injection for Intravenous Infusion | Jul 1, 2026 | Covered |