C9056 Injection, givosiran

Injection, givosiran, 0.5 mg

Payer policies and prior authorization for C9056

3 of 3 payer prior-auth lists that name C9056 require prior authorization or set conditions: Molina Healthcare of Ohio.

PayerPlanStatePrior authConditionsSinceSource
Molina Healthcare of OhioMedicaid and MyCare Ohio (MMP) MedicaidOHprior auth requiredOct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of OhioMedicare and MyCare Ohio (MMP) MedicareOHprior auth requiredOct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of OhioExchangeOHprior auth requiredOct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01

Payer coverage policies that name C9056

C9056 appears in 1 coverage policy from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaInjectable Medications (0020)listed, no stance (range C8957-C9235)Mar 5, 2026payer document

Recent prior-auth changes

  • Jan 1, 2023: PA added, Molina Healthcare of Ohio

Medicaid fee-for-service

  • WY: $0.00 (professional), effective Jul 1, 2020

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.