Specialty medical injectable drug program, requirements and drug policy updates for November

New specialty medical injectable updates and requirements announced November 2024.


Review the following tables to determine changes to our specialty medical injectable drug programs. 

Updates to drug program requirements and drug policies for UnitedHealthcare commercial business

Drug Name Effective Date Summary of Changes
Tremfya® IV (guselkumab)
 

2/1/25

  • Add prior authorization/notification
  • Add to site of care

UnitedHealthcare will honor all approved prior authorizations on file until the end date on the authorization or the date the member’s eligibility changes. Upon prior authorization renewal, the updated policy will apply.

Specialty medical injectable drugs added to Medication Sourcing for Outpatient Hospital Providers Only for UnitedHealthcare Commercial

Drug Name Effective Date HCPCS Code(s) Specialty Pharmacy

Tremfya IV
(guselkumab)

2/1/25 J3490/J3590/C9399
J3590
C9399
TBD

Review the UnitedHealthcare Commercial Plan Medication Sourcing List.

For questions, please contact your broker or UnitedHealthcare representative.

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