`G3001` Admin + supply, tositumomab

Administration and supply of tositumomab, 450 mg

Medicare coverage: Carrier judgment
Status: terminated 20161231

Payer policies and prior authorization for G3001

Payer coverage policies that name G3001

G3001 appears in 1 coverage policy from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Injectable Medications (0020)	listed, no stance	Mar 5, 2026	payer document

Medicaid fee-for-service

WY: $0.00 (professional), effective Jan 1, 2017

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.

G3001 Admin + supply, tositumomab

Payer policies and prior authorization for G3001

Payer coverage policies that name G3001

Medicaid fee-for-service

`G3001` Admin + supply, tositumomab