45 commercial payer policies list J3358. 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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45 policies from 21 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.
Showing 10 of 12 · All EviCore by Evernorth policies
| Policy | Effective | Status of J3358 |
|---|---|---|
| Stelara (ustekinumab)Effective 08/01/2023 - 11/30/2023 | Aug 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Stelara (ustekinumab)Effective 08/01/2024 - 03/31/2025 | Aug 1, 2024 | Prior auth requiredInferred from policy title |
| Stelara (ustekinumab)Effective 12/01/2023 - 07/31/2024 | Dec 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Ustekinumab (Stelara)Effective 02/01/2020 - 10/31/2020 | Feb 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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| Ustekinumab (Stelara)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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| Ustekinumab (Stelara)Effective 10/01/2022 - 07/31/2023 | 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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| Ustekinumab (Stelara)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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| Ustekinumab (Stelara)Effective 11/02/2018 - 01/31/2020 | Nov 2, 2018 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
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| Ustekinumab Intravenous (Stelara , Otulfi, Pyzchiva , Selarsdi, Steqeyma, Wezlana, Yesintek, ustekinumab-ttwe)Effective 06/01/2025 - 10/31/2025 | Jun 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Ustekinumab Intravenous (Stelara, Imuldosa, Otulfi, Pyzchiva, Selarsdi, Starjemza, Steqeyma, Wezlana, Yesintek, ustekinumab, ustekinumab-ttwe) | 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 J3358 |
|---|---|---|
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| Ustekinumab | Jul 1, 2026 | Covered |
| Ustekinumab – 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. |
| Ustekinumab – 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 J3358 |
|---|---|---|
| Measurement of Serum Antibodies to Infliximab, Adalimumab, Vedolizumab, and Ustekinumab | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Ustekinumab (e.g., Stelara) 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 J3358 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Ustekinumab and Associated Biosimilars | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J3358 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Ustekinumab and Associated Biosimilars | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J3358 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Ustekinumab and Associated Biosimilars | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J3358 |
|---|---|---|
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Ustekinumab and Associated Biosimilars | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J3358 |
|---|---|---|
| Ustekinumab Stelara IV | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Ustekinumab Stelara IV ME | 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 J3358 |
|---|---|---|
| Measurement of Serum Antibodies to Infliximab, Adalimumab, Ustekinumab and Vedolizumab | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Ustekinumab (Stelara) | 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 J3358 |
|---|---|---|
| Ustekinumab for Intravenous Infusion | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Ustekinumab for Intravenous Infusion | 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 J3358 |
|---|---|---|
| Ustekinumab Subcutaneous Products | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Yesintek (ustekinumab-kfce) and Starjemza (ustekinumab-hmny) 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 J3358 |
|---|---|---|
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| Ustekinumab | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J3358 |
|---|---|---|
| Ustekinumab for Intravenous Infusion | 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 J3358 |
|---|---|---|
| Ustekinumab and Associated Biosimilars | Jul 1, 2026 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J3358 |
|---|---|---|
| USTEKINUMAB PRODUCTS | 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 J3358 |
|---|---|---|
| Intravenous Ustekinumab for Inflammatory Bowel Disease. Medical Policy MP 5.01.664 Intravenous Ustekinumab for Inflammatory Bowel Disease DISCLAIMER/INSTRUCTIONS FOR USE This medical 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 J3358 |
|---|---|---|
| Ustekinumab Products: Ustekinumab (Stelara); Ustekinumab-auub (Wezlana); Ustekinumab-srlf (Imuldosa); Ustekinumab-aauz (Otulfi); Ustenkinumab-ttwe (Pyzchiva), Ustekinumab-aekn (Selarsdi); Ustenkinumab-stba (Steqeyma); Ustenkinumba-kfce (Yesintek); ustekinumab; ustekinumab-aauz, ustekinumab-stba, ustekinumab-aekn ; ustenkinumab-ttwe; Ustekinumab-hmny (Starjemza) | Mar 11, 2010 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J3358 |
|---|---|---|
| Ustekinumab (Stelara) | 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 J3358 |
|---|---|---|
| 00242 ustekinumab Products | 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 J3358 |
|---|---|---|
| Ustekinumab: Stelara; Wezlana; Selarsdi; Pyzchiva; Otulfi; Imuldosa; Yesintek; Steqeyma; Starjemza; Ustekinumab-aekn§; Ustekinumab-ttwe§; Ustekinumab-aauz§; Ustekinumab-stba§; Ustekinumab§ | 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 J3358 |
|---|---|---|
| Ustekinumab | Jul 1, 2026 | Covered |