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April 2017

Specific self-administered drugs will no longer be part of members’ medical benefit coverage

As of July 1, 2017, specific self-administered drugs will no longer be covered under members’ medical benefits. See the list of drugs and associated HCPCS codes below:

Drug name

HCPCS code

Avonex®/Rebif®

J1826 / Q3027 / Q3028

Betaseron®/Extavia®

J1830

Cabergoline

J8515

Clozapine

S0136

Copaxone®

J1595

Didanosine

S0137

Enbrel®

J1438

Forteo®

J3110

Fuzeon®

J1324

Humira®

J0135

Increlex®

J2170

Somatropin injection

J2941

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2016 American Medical Association. All rights reserved.
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