J8705 Topotecan oralTopotecan, oral, 0.25 mg
J8705 payment limit: $125.461 per 0.25 mg, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.
66758-0101-11 Hycamtin, Sandoz Inc.: 10 billing units per package (10 CAPSULE in 1 BOTTLE)66758-0102-11 Hycamtin, Sandoz Inc.: 40 billing units per package (10 CAPSULE in 1 BOTTLE)Status E: excluded from the PFS by regulation.
1 of 1 payer prior-auth lists that name J8705 require prior authorization or set conditions: HealthSpring.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| HealthSpring | Medicare Advantage | All | prior auth required | Jan 1, 2025 | 2026 Q4 Prior Authorization List |
J8705 appears in 3 coverage policies from Aetna, Centene.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Antiemetic Therapy (0724) | listed, no stance | Jul 17, 2026 | payer document |
| Aetna | Revakinagene Taroretcel-lwey (Encelto) (1079) | listed, no stance (range J8501-J9999) | Oct 5, 2026 | payer document |
| Centene | Topotecan (Hycamtin) (CP.PHAR.64) | covered if criteria are met | May 1, 2026 | payer document |
Prior authorization required or conditional in IN.
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.