32 commercial payer policies list J9333. 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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32 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.
| Policy | Effective | Status of J9333 |
|---|---|---|
| Rystiggo (rozanolixizumab-noli) | Dec 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Rystiggo (rozanolixizumab-noli)Effective 12/01/2023 - 11/30/2024 | Dec 1, 2023 | Prior auth requiredInferred from policy title |
| Rystiggo (rozanolixizumab-noli)Effective 12/01/2024 - 11/30/2025 | Dec 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Policy | Effective | Status of J9333 |
|---|---|---|
| Rozanolixizumab-noli (Rystiggo) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Rozanolixizumab-noli (Rystiggo) | 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 J9333 |
|---|---|---|
| Rozanolixixumab-noli | Dec 15, 2025 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J9333 |
|---|---|---|
| Rozanolixixumab-noli | Dec 15, 2025 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J9333 |
|---|---|---|
| Rozanolixixumab-noli | Dec 15, 2025 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J9333 |
|---|---|---|
| Rozanolixixumab-noli | Dec 15, 2025 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J9333 |
|---|---|---|
| Rozanolixizumab-noli (Rystiggo) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Rozanolixizumab-noli (Rystiggo) | 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 J9333 |
|---|---|---|
| Rystiggo (rozanolixizumab-noli) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Rystiggo (rozanolixizumab-noll) | 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 J9333 |
|---|---|---|
| FcRn Blockers | Oct 1, 2026 | Covered |
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| Policy | Effective | Status of J9333 |
|---|---|---|
| FcRn Blockers | Oct 1, 2026 | Covered |
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| Policy | Effective | Status of J9333 |
|---|---|---|
| Rozanolixizumab-noli (e.g., Rystiggo) | 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 J9333 |
|---|---|---|
| ULTOMIRIS, PIASKY, UPLIZNA, EMPAVELI, PIASKY,RYSTIGGO, IMAAVY | 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 J9333 |
|---|---|---|
| RYSTIGGO (ROZANOLIXIZUMAB-NOLI) | 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 J9333 |
|---|---|---|
| Rozanolixizumab‐noli (Rystiggo) | Sep 30, 2023 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J9333 |
|---|---|---|
| Rystiggo | 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 J9333 |
|---|---|---|
| Rozanolixizumab-noli (Rystiggo); CP.PHAR.648 | 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 J9333 |
|---|---|---|
| Neonatal Fc receptor antagonists (Vyvgart, Vyvgart Hytrulo, Rystiggo, Imaavy) | 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 J9333 |
|---|---|---|
| 00865 rozanolixizumab-noli (Rystiggo) | 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 J9333 |
|---|---|---|
| Rystiggo (rozanolixizumab-noli) | 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 J9333 |
|---|---|---|
| Rystiggo (rozanolixizumab-noli) (PG190, Ver. 4) | 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 J9333 |
|---|---|---|
| FcRn Blockers | Oct 1, 2026 | Covered |