22 commercial payer policies list J9356. 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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22 policies from 19 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 J9356 |
|---|---|---|
| Trastuzumab (Herceptin) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Trastuzumab (Herceptin) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta) | Not recorded | Covered with conditionsInferred from policy title |
| Policy | Effective | Status of J9356 |
|---|---|---|
| Oncology - ado-trastuzumab emtansine (Kadcyla), pertuzumab (Perjeta), trastuzumab (Herceptin, Herzuma, Kanjinti, Ogivri, Ontruzant, Trazimera), and trastuzumab and hyaluronidase-oysk (Herceptin Hylecta) – Minnesota Health Care Programs | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Oncology - trastuzumab (Herceptin, Herzuma, Kanjinti, Ogivri, Ontruzant, Trazimera), and trastuzumab and hyaluronidase-oysk (Herceptin Hylecta) | 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 J9356 |
|---|---|---|
| Trastuzumab (Herceptin) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Trastuzumab (Herceptin) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta) | 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 J9356 |
|---|---|---|
| Trastuzumab Products | Feb 15, 2024 | Covered |
| Policy | Effective | Status of J9356 |
|---|---|---|
| Trastuzumab (e.g., Herceptin) and Biosimilars and Trastuzumab/Hyaluronidase-oysk (e.g., Herceptin Hylecta) | 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 J9356 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J9356 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J9356 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J9356 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J9356 |
|---|---|---|
| HERCEPTIN HYLECTA (TASTUZUMAB AND HYALURONIDASE-OYSK FOR SUBCUTANEOUS INJECTION) | 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 J9356 |
|---|---|---|
| Trastuzumab Herceptin Trastuzumab Biosimilars AND Trastuzumab AND Hyaluronidase Oysk Herceptin Hylecta | 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 J9356 |
|---|---|---|
| Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta) | Jul 31, 2019 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J9356 |
|---|---|---|
| Cigna MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J9356 |
|---|---|---|
| Q3 - 2026 Jefferson Health Plans MedOnc Master Drug List | Not recorded | Prior auth required |
| Policy | Effective | Status of J9356 |
|---|---|---|
| Trastuzumab (Herceptin), Trastuzumab-dkst (Ogivri), Ado-trastuzumab emtansine (Kadcyla), Trastuzumab-pkrb (Herzuma), Trastuzumab-dttb (Ontruzant), Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta), Trastuzumab-qyyp (Trazimera), Trastuzumab-anns (Kanjinti), Fam-trastuzumab deruxtecan-nxki (Enhertu), Pertuzumab (Perjeta), and Pertuzumab, Trastuzumab, and hyaluronidase-zzxf (Phesgo) | 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 J9356 |
|---|---|---|
| Herceptin Hylecta (trastuzumab and hyaluronidase-oysk) | 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 J9356 |
|---|---|---|
| Oncology Medication Clinical Coverage | Sep 1, 2026 | Covered |
| Policy | Effective | Status of J9356 |
|---|---|---|
| Oncology Medication Clinical Coverage | Sep 1, 2026 | Covered |
| Policy | Effective | Status of J9356 |
|---|---|---|
| Oncology Medication Clinical Coverage | Sep 1, 2026 | Covered |