Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
J6 · Effective Oct 1, 2015
3 active Medicare policies list J9218, and 13 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 Oct 1, 2025
13 policies from 7 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of J9218 |
|---|---|---|
| Alzheimer's Disease: Experimental, Investigational, or Unproven Treatments | Feb 20, 2024 | Covered |
| Benign Prostatic Hyperplasia | Feb 8, 2024 | Covered |
| Gonadotropin-Releasing Hormone Analogs and Antagonists | Jul 14, 2023 | Covered |
| Policy | Effective | Status of J9218 |
|---|---|---|
| Gonadotropin-Releasing Hormone (GnRH) Agonists and Antagonists | Aug 15, 2025 | Covered |
| Oncology Medications |
| Jul 1, 2026 |
| Covered |
| Policy | Effective | Status of J9218 |
|---|---|---|
| Gonadotropin-Releasing Hormone (GnRH) Agonists and Antagonists | Aug 15, 2025 | Covered |
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J9218 |
|---|---|---|
| Gonadotropin-Releasing Hormone (GnRH) Agonists and Antagonists | Aug 15, 2025 | Covered |
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J9218 |
|---|---|---|
| Gonadotropin-Releasing Hormone (GnRH) Agonists and Antagonists | Aug 15, 2025 | Covered |
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J9218 |
|---|---|---|
| Cigna MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J9218 |
|---|---|---|
| Q3 - 2026 Jefferson Health Plans MedOnc Master Drug List | Not recorded | Prior auth required |