J0607 Lanthanum carbonate oral 5mgLanthanum carbonate, oral, 5 mg (for esrd on dialysis)
Status E: excluded from the PFS by regulation.
3 of 7 payer prior-auth lists that name J0607 require prior authorization or set conditions: Humana, Molina Healthcare of California, Molina Healthcare of Michigan.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Humana | Humana Healthy Horizons | OK | prior auth required | Oct 14, 2026 | Humana Healthy Horizons in Oklahoma Prior Authorization and Notification List | |
| Molina Healthcare of California | Medicaid | CA | prior auth required | Apr 1, 2026 | Medicaid Prior Auth (PA) Code Matrix (California), effective Q2 2026 | |
| Molina Healthcare of Michigan | Medicaid | MI | prior auth required | Jul 1, 2026 | Molina Healthcare of Michigan PA Matrix 2026-Q3 |
J0607 appears in 2 coverage policies from Aetna, Centene.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Injectable Medications (0020) | listed, no stance (range J0278-J2543) | Mar 5, 2026 | payer document |
| Centene | Non-Calcium Phosphate Binders (CP.PMN.04) | covered if criteria are met | Feb 1, 2026 | payer document |
Prior authorization required or conditional in VT.
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.