2023/5/4
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Posted by Provider Relations
Due to the FDA withdrawing approval of Makena and its generics on June 1, 2023, Fidelis will no longer be covering Makena or its generics, unless otherwise noted.
The following HCPCS codes are affected:
- J1726 (Injection, hydroxyprogesterone caproate, (Makena), 10 mg) will deny as non-covered benefit.
- J1729 (Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg) will be excluded from coverage for preterm birth indications. Beginning June 1, 2023, prior authorization (PA) will be required for non-pregnancy related indications.
Please see the following FDA website for further information: https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/makena-hydroxyprogesterone-caproate-injection-information