12 commercial payer policies list J9304. 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.
Free account. Policy pages stay open to everyone.
12 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 J9304 |
|---|---|---|
| Pemetrexed (Pemfexy) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Pemetrexed (Pemfexy) | Not recorded | Covered with conditionsInferred from policy title |
| Policy | Effective | Status of J9304 |
|---|---|---|
| Pemetrexed (Pemfexy) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Pemetrexed (Pemfexy) | 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 J9304 |
|---|---|---|
| Pemetrexed (Alimta; Pemfexy, Pemetrexed, Pemrydi RTU, Axtle) | Oct 8, 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 J9304 |
|---|---|---|
| Cigna MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J9304 |
|---|---|---|
| Pemetrexed (Alimta, Pemfexy, Axtle); CP.PHAR.368 | 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 J9304 |
|---|---|---|
| Q4 - 2026 JHP MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J9304 |
|---|---|---|
| Pemetrexed: Alimta; Pemfexy; Pemrydi RTU; Axtle; Pemetrexed Ψ | 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 J9304 |
|---|---|---|
| Oncology Medication Clinical Coverage | Sep 1, 2026 | Covered |
| Policy | Effective | Status of J9304 |
|---|---|---|
| Oncology Medication Clinical Coverage | Sep 1, 2026 | Covered |
| Policy | Effective | Status of J9304 |
|---|---|---|
| Oncology Medication Clinical Coverage | Sep 1, 2026 | Covered |