13 commercial payer policies list J3396. 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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13 policies from 10 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 J3396 |
|---|---|---|
| Age-Related Macular Degeneration | Feb 20, 2024 | Covered |
| Verteporfin (Visudyne) Photodynamic Therapy | Jun 29, 2023 | Covered |
| Policy | Effective | Status of J3396 |
|---|---|---|
| Photodynamic Therapy (PDT) Using Verteporfin (Visudyne) | Not recorded | Covered with conditionsInferred from policy title |
| Photodynamic Therapy Using Verteporfin (Visudyne) | 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 J3396 |
|---|---|---|
| Photodynamic Therapy (PDT) Using Verteporfin (Visudyne) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Photodynamic Therapy Using Verteporfin (Visudyne) | 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 J3396 |
|---|---|---|
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of J3396 |
|---|---|---|
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of J3396 |
|---|---|---|
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of J3396 |
|---|---|---|
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of J3396 |
|---|---|---|
| Verteporfin (Visudyne) | Dec 1, 2016 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J3396 |
|---|---|---|
| Verteporfin (Visudyne)Effective 12/01/2018 - 10/31/2019 | Dec 1, 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 J3396 |
|---|---|---|
| Verteporfin (Visudyne); CP.PHAR.187 | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |