Specialty medical injectable medication program, requirement and policy updates May 2026
Review the following tables to determine changes to our specialty medical injectable medication programs and drug policy updates for May 2026.
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 medications have been added to Review at Launch:
| Medication name | HCPCs code(s) |
| Avlayah™ (tividenofusp alfa-eknm) |
J3490/J3590/C9399 |
| Ponlimsi™ (denosumab-adet) Biosimilar to Prolia® |
J3490/J3590/C9399 |
Note: Medications added to Review at Launch may not yet be available in the marketplace.
Review the UnitedHealthcare Commercial Plan Review at Launch Medication List.
For questions, please contact your broker or UnitedHealthcare representative.
Updates to drug program requirements and drug policies
Effective August 1, 2026, the site of care program is being expanded to include select oncology medications and the following drug program requirements and drug policy updates will be made to UnitedHealthcare commercial business:
| Medication name | HCPCs code(s) | Summary of changes |
| Darzalex Faspro® (daratumumab and hyaluronidase-fihj) |
J9144 |
|
| Imfinzi® (durvalumab) |
J9173 |
|
| Jemperli (dostarlimab-gxly) |
J9272 |
|
| Keytruda® (pembrolizumab) |
J9271 |
|
| Keytruda Qlex™ (pembrolizumab and berahyaluronidase alfa-pmph) |
J9277 |
|
| Libtayo® (cemiplimab-rwlc) |
J9119 |
|
| Opdivo® (nivolumab) |
J9229 |
|
| Opdivo Qvantig® (nivolumab and hyaluronidase-nvhy) |
J9289 |
|
| Opdualag™ (nivolumab and relatlimab-rmbw) |
J9298 |
|
| Phesgo® (pertuzumab, trastuzumab, and hyaluronidase-zzxf) |
J9316 |
|
| Tecentriq® (atezolizumab) |
J9022 |
|
| Tecentriq Hybreza™ (atezolizumab and hyaluronidase-tqjs) |
J9024 |
|
| Yervoy® (ipilimumab) |
J9228 |
|
For additional information, please refer to: https://www.uhcprovider.com/en/resource-library/news/2026/oncology-drugs-site-care-policy.html
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.
Note: Certain specialty medical injectable programs and updates may not be implemented for some providers or commercial members where prohibited by applicable state insurance mandates or regulations. Providers are encouraged to confirm whether prior authorization or other program requirements apply.
For questions, please contact your broker or UnitedHealthcare representative.