C9308 Inj, carboplatin (avyxa)

Injection, carboplatin (avyxa), 1 mg

Payer policies and prior authorization for C9308

1 of 2 payer prior-auth lists that name C9308 require prior authorization or set conditions: Molina Healthcare of Michigan.

PayerPlanStatePrior authConditionsSinceSource
Molina Healthcare of MichiganMedicare AdvantageMIprior auth requiredJul 1, 2026Molina Healthcare of Michigan PA Matrix 2026-Q3

Payer coverage policies that name C9308

C9308 appears in 3 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaLurbinectedin (Zepzelca) (0978)listed, no stanceMar 11, 2026payer document
AetnaRetifanlimab-dlwr (Zynyz) (1030)listed, no stanceApr 27, 2026payer document
AetnaToripalimab-tpzi (Loqtorzi) (1049)listed, no stanceOct 5, 2026payer document

Recent prior-auth changes

  • Aug 1, 2026: PA removed, HealthSpring
  • Apr 1, 2026: PA added, HealthSpring
  • Apr 1, 2026: PA removed, Molina Healthcare of Illinois
  • Apr 1, 2026: PA removed, Passport by Molina Healthcare (Kentucky)
  • Mar 31, 2026: PA removed, Cigna
  • Mar 31, 2026: PA removed, Cigna
  • Mar 31, 2026: PA removed, Cigna
  • Jan 1, 2026: PA added, Passport by Molina Healthcare (Kentucky)
  • Jan 1, 2026: PA added, Molina Healthcare of Michigan
  • Jan 1, 2026: PA added, Molina Healthcare of Illinois

Medicaid fee-for-service

  • AZ: $4.12 (outpatient_hospital), effective Jan 1, 2026
  • FL: $972.00 (physician_administered_drugs), effective Jan 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

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.