Maine
Provider Communications
AMH Health, LLC expands specialty pharmacy precertification list
Federal and state law, as well as state contract language and CMS guidelines, including definitions and specific contract provisions/exclusions, take precedence over these precertification rules and must be considered first when determining coverage. Noncompliance with new requirements may result in denied claims.
HCPCS or CPT® codes |
Medicare Part B drugs |
C9399, J3490, J3590, J9999 |
Opdualag (nivolumab and relatlimab-rmbw) |
C9096 |
Releuko (filgrastim-ayow) |
A9699 |
Pluvicto (lutetium lu 177 vipivotide tetraxetan) |
Featured In:
November 2022 Provider Newsletter - Maine