Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
J6 · Effective Oct 1, 2015
3 active Medicare policies list J3316, and 21 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 Apr 1, 2026
21 policies from 12 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 J3316 |
|---|---|---|
| Triptodur (triptorelin extended-release suspension) | Nov 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Triptodur (triptorelin extended-release suspension)Effective 11/01/2024 - 10/31/2025 | Nov 1, 2024 | Prior auth requiredInferred from policy title |
| Triptodur (triptorelin)Effective 11/01/2023 - 10/31/2024 | Nov 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Triptorelin Extended-Release Suspension (Triptodur) - OscarEffective 06/01/2018 - 07/14/2018 | Jun 1, 2018 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Triptorelin Extended-Release Suspension (Triptodur)Effective 01/01/2022 - 11/30/2022 | Jan 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Triptorelin Extended-Release Suspension (Triptodur)Effective 04/01/2019 - 04/30/2020 | Apr 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Triptorelin Extended-Release Suspension (Triptodur)Effective 04/01/2021 - 12/31/2021 | Apr 1, 2021 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Triptorelin Extended-Release Suspension (Triptodur)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. |
|---|
| Triptorelin Extended-Release Suspension (Triptodur)Effective 07/15/2018 - 03/31/2019 | Jul 15, 2018 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Triptorelin Extended-Release Suspension (Triptodur)Effective 12/01/2022 - 10/31/2023 | Dec 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Policy | Effective | Status of J3316 |
|---|---|---|
| Triptorelin (e.g., Triptodur, Trelstar) | 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 J3316 |
|---|---|---|
| Gonadotropin-Releasing Hormone (GnRH) Agonists and Antagonists | Aug 15, 2025 | Covered |
| Policy | Effective | Status of J3316 |
|---|---|---|
| Gonadotropin-Releasing Hormone (GnRH) Agonists and Antagonists | Aug 15, 2025 | Covered |
| Policy | Effective | Status of J3316 |
|---|---|---|
| Gonadotropin-Releasing Hormone (GnRH) Agonists and Antagonists | Aug 15, 2025 | Covered |
| Policy | Effective | Status of J3316 |
|---|---|---|
| Gonadotropin-Releasing Hormone (GnRH) Agonists and Antagonists | Aug 15, 2025 | Covered |
| Policy | Effective | Status of J3316 |
|---|---|---|
| TRIPTORELIN: TRIPTODUR (J3315) retired as of 10/8/2020 | 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 J3316 |
|---|---|---|
| Triptorelin (Triptodur) | Jan 18, 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 J3316 |
|---|---|---|
| Triptorelin pamoate (Trelstar, Triptodur); CP.PHAR.175 | 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 J3316 |
|---|---|---|
| Gonadotropin Releasing Hormone Analogs | Jul 1, 2025 | Covered |
| Policy | Effective | Status of J3316 |
|---|---|---|
| Gonadotropin Releasing Hormone Analogs | Jul 1, 2025 | Covered |
| Policy | Effective | Status of J3316 |
|---|---|---|
| Gonadotropin Releasing Hormone Analogs | Jul 1, 2025 | Covered |