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

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

June 27, 2025

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

Review at launch
The following specialty medical injectable medication has been added to Review at Launch:

Medication Name HCPCs Code(s)
Imaavy™
(nipocalimab-aahu)		 J3490/J3590/C9399

Note: Medications added to Review at Launch may not yet be available in the marketplace.

Medication Sourcing for Outpatient Hospital Providers Only
Effective Jul. 1, 2025, the following specialty medical injectable medications are being added to Medication Sourcing for Outpatient Hospital Providers Only:

Medication Name HCPCs Code(s) Specialty Pharmacy
Niktimvo™
(axatilimab-csfr)

J9038

 Caremark (CVS Specialty)
Otulfi®
(ustekinumab-aauz)
Biosimilar to Stelara®		 Q9999 Amber Specialty Pharmacy
Optum Specialty Pharmacy
Pyzchiva®
(ustekinumab-ttwe)
Biosimilar to Stelara		 Q9996, Q9997 Amber Specialty Pharmacy
Selarsdi™
(ustekinumab-aekn)
Biosimilar to Stelara		 Q9998 Amber Specialty Pharmacy
Steqeyma®
(ustekinumab-stba)
Biosimilar to Stelara		 Q5099 Accredo Health Group
Amber Specialty Pharmacy
Caremark (CVS Specialty)

Wezlana™
(ustekinumab-auub)
Biosimilar to Stelara

 Q5137, Q5138 Optum Specialty Pharmacy

Yesintek™
(ustekinumab-kfce)
Biosimilar to Stelara

 Q5100

Accredo Health Group
Amber Specialty Pharmacy
Caremark (CVS Specialty)

Review the UnitedHealthcare Commercial Plan Medication Sourcing List.

For questions, please contact your broker or UnitedHealthcare representative.

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