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HCPCS/CPT C9306, Injection, telisotuzumab vedotin-tllv, 1 mg | Prior Auth Required

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`C9306`, Injection, telisotuzumab vedotin-tllv, 1 mg

HCPCS/CPT

Prior Authorization

Prior Auth Required

Code explicitly requires prior authorization (high confidence)

3 Active Policies

EVICORE-HPLAN-CIGNA_MEDICARE-6408D93491D1, Q1 - 2026 1199 SEIU Benefit Funds MedOnc Master Drug List

EVICORE-HPLAN-CIGNA_MEDICARE-44F27329FED1, Q4 - 2025 1199 SEIU Benefit Funds MedOnc Master Drug List

EVICORE-HPLAN-HEALTH_PARTNERS_PLANS-1D3B8C21C093, Q2 - 2026 Health Partners Plans MedOnc Master Drug List

Related Codes

J0640(3 policies)J0641(3 policies)C9399(3 policies)J0185(3 policies)J0208(3 policies)

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J0209(3 policies)

J0584(3 policies)

J0642(3 policies)