Feb 1, 2024

PA Requirement changes for Medicare Members

Effective April 1, 2024, there will be changes to three pharmacy codes regarding their prior authorization requirements:

Removal of Prior Authorization

Synvisc (J7325) 

Adding Prior Authorization

Duralane (J7318) 

Orthovisc (J7324) 

Removal of prior authorization 

Effective April 1, 2024, the prior authorization requirement will be removed from Angioplasty and Stent, Carotid: CPT Codes 37215, 37216, 37217.