April 01, 2022

Updates to the oncology specialty pharmacy requirement for commercial plan members

Effective for dates of service on or after April 1, 2022, the medication sourcing requirement for the following oncology supportive care medications will no longer apply for outpatient hospital providers:

Medication Name Therapeutic Class Code

Fulphila®

Colony-stimulating factor

Q5108

Neulasta®

Colony-stimulating factor

J2506

NyvepriaTM

Colony-stimulating factor

Q5122

Udenyca®

Colony-stimulating factor

Q5111

Ziextenzo®

Colony-stimulating factor

Q5120

Questions? Please contact your Network Management or Provider Relations teams.

PCA-22-00946-PH-News