Medications to be added to our Medical Injectables Program: February 2019
Effective February 1, 2019, additional injectable medications will be included as part of our Medical Injectables Program (MIP) administered by Magellan Rx Management℠.
Beginning with services to be provided on and after February 1, 2019, Magellan Rx Management will conduct medical necessity and appropriateness reviews (MNARs) for the additional injectable medications represented by the new HCPCS codes below when these medications are administered in a freestanding or hospital-based dialysis center, an outpatient facility, a patient’s home or a physician’s office.¹
|Generic Name||Brand Name||HCPCS|
|DAUNORUBICIN; CYTARABINE LIPOSOMAL||VYXEOS||J9153|
|HYALURONAN OR DERIVATIVE||DUROLANE||J7318|
|HYALURONAN OR DERIVATIVE||TRIVISC||J7329|
Review the revised list of injectable medications that currently require MNAR as part of the MIP, or learn more about our Medical Injectables Program.
If you have questions, please contact your Network Specialist.
¹ Medical necessity and appropriateness review 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 health care professionals to obtain pre-service determination.
Magellan Rx Management℠ is a service mark of Magellan Health, Inc