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Additional Medication to be Added to Our Medical Injectables Program

Additional Medication to be Added to Our Medical Injectables Program

Effective October 15, 2017, the additional injectable medication listed below will be included as part of our Medical Injectables Program (MIP) administered by Magellan Rx ManagementSM.

Brand name

Generic Name

HCPCS Code

Effective Date

RITUXAN HYCELATM

RITUXIMAB/HYALURIDASE

J9999

October 15, 2017

Beginning with services to be provided on and after October 15, 2017, Magellan Rx Management will conduct medical necessity and appropriateness reviews (MNARs) for this additional injectable medication (recently approved by the FDA) when administered in a freestanding or hospital-based dialysis center, an outpatient facility, a patient’s home, or a physician’s office.1

Review the complete list of injectable medications that currently require MNAR as part of the MIP.

If you have questions, please contact your Network Specialist.

1 MNAR is not required for injectable medications that are administered during an inpatient stay, or in an Emergency Room setting or Observation Room setting.

For medical injectable services rendered in the patient’s home, call 1-855-243-3321 for participating Horizon Care@Home providers to obtain pre-service determination.


Work Smarter with Magellan Rx Management

Follow these best practices to save time when working with Magellan Rx Management:

  • Avoid delays in claim processing and reimbursement by always obtaining pre-service MNAR of injectable medications for your patients.
  • Avoid time spent waiting on the phone by submitting and managing your MNAR requests through Magellan Rx Management’s secure website, MagellanRx.com.

If you don’t already have a Magellan Rx Management username and password, we encourage you to request them today.

  • Visit MagellanRx.com.
  • Click the Providers and Physicians icon.
  • Click New User Request Access (within the yellow Sign In section).
  • Click Contact Us.
  • Complete the required fields and then click Send.

Magellan Rx Management will respond with a username, password and quick start guide within two business days.

Visit our Medical Injectables Program page for more information.

Magellan Rx ManagementSM is a service mark of Magellan Health, Inc

Rituxan HycelaTM is a trademark of Genentech, Inc.

Published on: September 15, 2017, 12:24 p.m. ET
Last updated on: September 15, 2017, 12:26 p.m. ET