Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
J6 · Effective Oct 1, 2015
3 active Medicare policies list J9035, and 42 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 Jul 1, 2026
42 policies from 22 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 J9035 |
|---|---|---|
| Avastin (bevacizumab) Non-oncology | Not recorded | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Avastin (bevacizumab) Non-oncologyEffective 06/01/2024 - 05/31/2025 | Jun 1, 2024 | Prior auth requiredInferred from policy title |
| Avastin (bevacizumab) Non-oncologyEffective 06/01/2025 - 05/31/2026 | Jun 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Bevacizumab (Avastin)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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| Bevacizumab (Avastin)Effective 12/01/2018 - 11/30/2019 | Dec 1, 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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| Bevacizumab (Avastin)Effective 12/01/2019 - 10/31/2020 | Dec 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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| Policy | Effective | Status of J9035 |
|---|---|---|
| Age-Related Macular Degeneration | Feb 20, 2024 | Covered |
| Cerebral Perfusion Studies | Sep 14, 2023 | Covered |
| Glaucoma Surgery | Mar 24, 2023 | Covered |
| Hypertrophic Scars and Keloids | Jun 22, 2023 | Covered |
| Policy | Effective | Status of J9035 |
|---|---|---|
| Bevacizumab (e.g., Avastin) and Biosimilars for Non-Oncologic and Non-Ophthalmologic Indications | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Bevacizumab (e.g., Avastin) and Biosimilars for Oncologic Indications | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Bevacizumab (e.g., Avastin) and Biosimilars for Ophthalmic Use | 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 J9035 |
|---|---|---|
| Bevacizumab (Avastin) and Related Biosimilars For Oncologic Use | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Bevacizumab (Avastin) and Related Biosimilars For Oncologic Use | 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 J9035 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of J9035 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of J9035 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of J9035 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Photodynamic Therapy for Choroidal Neovascularization | Dec 15, 2025 | Covered |
| Policy | Effective | Status of J9035 |
|---|---|---|
| Bevacizumab (Avastin) and Related Biosimilars For Oncologic Use | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Bevacizumab (Avastin) and Related Biosimilars For Oncologic Use | 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 J9035 |
|---|---|---|
| Bevacizumab: Alymsys; Avastin; Avzivi; Jobevne; Mvasi; Vegzelma; Zirabev | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Bevacizumab: Avastin; Mvasi; Zirabev (Intravitreal) | 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 J9035 |
|---|---|---|
| Oncology Medication Clinical Coverage | Sep 1, 2026 | Covered |
| Ophthalmologic Vascular Endothelial Growth Factor (VEGF) Inhibitors | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J9035 |
|---|---|---|
| Oncology Medication Clinical Coverage | Sep 1, 2026 | Covered |
| Ophthalmologic Vascular Endothelial Growth Factor (VEGF) Inhibitors | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J9035 |
|---|---|---|
| Oncology Medication Clinical Coverage | Sep 1, 2026 | Covered |
| Ophthalmologic Vascular Endothelial Growth Factor (VEGF) Inhibitors | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J9035 |
|---|---|---|
| AVASTIN (BEVACIZUMAB) ONCOLOGIC USE | 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 J9035 |
|---|---|---|
| Bevacizumab Avastin AND Bevacizumab 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 J9035 |
|---|---|---|
| Bevacizumab Products (Avastin; Mvasi ; Zirabev; Alymsys; Vegzelma, Avzivi, Jobevne) | Feb 1, 2005 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J9035 |
|---|---|---|
| Cigna MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J9035 |
|---|---|---|
| Bevacizumab (Avastin) for Oncologic Use | 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 J9035 |
|---|---|---|
| Bevacizumab (Alymsys, Avastin, Avzivi, Jobevne, Mvasi, Vegzelma, Zirabev); CP.PHAR.93 | 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 J9035 |
|---|---|---|
| Q4 - 2026 JHP MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J9035 |
|---|---|---|
| Oncology - bevacizumab (Avastin, Mvasi, Zirabev, Alymsys, Vegzelma, Jobevne) | 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 J9035 |
|---|---|---|
| Avastin (bevacizumab) for ophthalmic conditions ONLY | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |