Specialty medical injectable medication program, requirement and policy updates December 2025

Review the following tables to determine changes to our specialty medical injectable medication programs and drug policy updates for December 2025.

Jan. 16, 2026

Review the following tables to determine changes to our specialty medical injectable medication programs and drug policy updates.

Medication Sourcing for Outpatient Hospital Providers Only
Effective Jan. 1, 2026, the following specialty medical injectable medications are being added to Medication Sourcing for Outpatient Hospital Providers Only:

Medication Name HCPCs Code(s)

Specialty Pharmacy

Bkemv®
(eculizumab-aeeb)		 Q5152 Caremark (CVS Specialty)
Epysqli®
(eculizumab-aagh)		 Q5151 Caremark (CVS Specialty)
Jubbonti®
(denosumab-bbdz)

Q5136

 Amber Specialty Pharmacy
Option Care Health
Imuldosa®
(ustekinumab-srlf)		 Q5098 Amber Specialty Pharmacy
Yimmugo
(immune globulin intravenous, human-dira)		 J1599/J3490/J3590/C9399 Option Care Health

Review the UnitedHealthcare Commercial Plan Medication Sourcing List.

For questions, please contact your broker or UnitedHealthcare representative.

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