20 commercial payer policies list Q5134. 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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20 policies from 13 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 Q5134 |
|---|---|---|
| Natalizumab (Tyruko & Tysabri) | Jul 1, 2026 | Covered |
| Natalizumab (Tyruko & Tysabri) – Community Plan Medical Benefit Drug Policy | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Natalizumab (Tyruko & Tysabri) – Individual Exchange Medical Benefit Drug Policy |
| 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 Q5134 |
|---|---|---|
| Natalizumab and Associated Biosimilar(s) | May 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of Q5134 |
|---|---|---|
| Natalizumab and Associated Biosimilar(s) | May 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of Q5134 |
|---|---|---|
| Natalizumab and Associated Biosimilar(s) | May 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of Q5134 |
|---|---|---|
| Natalizumab and Associated Biosimilar(s) | May 1, 2026 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of Q5134 |
|---|---|---|
| Natalizumab (Tysabri, Tyruko) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Natalizumab (Tysabri, Tyruko) - 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. |
| Policy | Effective | Status of Q5134 |
|---|---|---|
| Natalizumab (Tysabri), Natalizumab-sztn (Tyruko) | Jan 13, 2007 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of Q5134 |
|---|---|---|
| Natalizumab Products (Tysabri, Tyruko) | Feb 1, 2026 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of Q5134 |
|---|---|---|
| Natalizumab (Tysabri) Natalizumab-sztn (Tyruko); CP.PHAR.259 | 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 Q5134 |
|---|---|---|
| Natalizumab: (Tysabri; Tyruko) | 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 Q5134 |
|---|---|---|
| Natalizumab and Natalizumab Biosimilars (Tysabri, Tyruko) (PG195, Ver. 6) | 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 Q5134 |
|---|---|---|
| Natalizumab (Tyruko & Tysabri) | Jul 1, 2026 | Covered |
| Policy | Effective | Status of Q5134 |
|---|---|---|
| Natalizumab (Tyruko & Tysabri) | Jul 1, 2026 | Covered |