J9098 Cytarabine liposome inj

Injection, cytarabine liposome, 10 mg

Payer policies and prior authorization for J9098

18 of 19 payer prior-auth lists that name J9098 require prior authorization or set conditions: HealthSpring, Molina Complete Care (Virginia), Molina Healthcare of Arizona, Molina Healthcare of California, Molina Healthcare of Florida, Molina Healthcare of Idaho, Molina Healthcare of Iowa, Molina Healthcare of Michigan, Molina Healthcare of Nevada, Molina Healthcare of New Mexico, Molina Healthcare of Ohio, Molina Healthcare of South Carolina, Molina Healthcare of Utah, Molina Healthcare of Washington, Molina Healthcare of Wisconsin, Molina Healthcare, Inc. (national grid).

PayerPlanStatePrior authConditionsSinceSource
HealthSpringMedicare AdvantageAllprior auth requiredAug 1, 20262026 Q4 Prior Authorization List
Molina Complete Care (Virginia)Medicare-only PA matrix for D-SNPVAprior auth requiredJan 1, 2022Medicare Prior Auth (PA) Code Matrix (Virginia), effective Q1 2022
Molina Healthcare of ArizonaMedicare-only PA matrix for D-SNPAZprior auth requiredJan 1, 2022Medicare Prior Auth (PA) Code Matrix (Arizona), effective Q1 2022
Molina Healthcare of CaliforniaMedicare AdvantageCAprior auth requiredJul 1, 2021Medicare Prior Auth (PA) Code Matrix (California), effective Q3 2021
Molina Healthcare of FloridaMedicare AdvantageFLprior auth requiredApr 1, 2021Medicare Prior Auth (PA) Code Matrix (Florida), effective Q2 2021
Molina Healthcare of IdahoMedicare AdvantageIDprior auth requiredApr 1, 2021Medicare Prior Auth (PA) Code Matrix (Idaho), effective Q2 2021
Molina Healthcare of IowaMedicaidIAprior auth requiredJul 1, 2023IA Prior Authorization Matrix, effective Q3 2023
Molina Healthcare of MichiganExchangeMIprior auth requiredJul 1, 2021Molina Healthcare of Michigan PA Matrix, effective 7/1/2021
Molina Healthcare of NevadaMedicaidNVprior auth requiredcancer dx via NCHOct 1, 2022Medicaid Prior Auth (PA) Code Matrix, effective Q4 2022
Molina Healthcare of New MexicoMedicare AdvantageNMprior auth requiredJan 1, 2021Medicare Prior Auth (PA) Code Matrix (New Mexico), effective Q1 2021
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
Molina Healthcare of South CarolinaMedicare AdvantageSCprior auth requiredApr 1, 2021Medicare Prior Auth (PA) Code Matrix (South Carolina), effective Q2 2021
Molina Healthcare of UtahMedicare AdvantageUTprior auth requiredApr 1, 2021Medicare Prior Auth (PA) Code Matrix (Utah), effective Q2 2021
Molina Healthcare of WashingtonMedicare AdvantageWAprior auth requiredApr 1, 2021Medicare Prior Auth (PA) Code Matrix (Washington), effective Q2 2021
Molina Healthcare of WisconsinMedicare AdvantageWIprior auth requiredOct 1, 2021Medicare Prior Auth (PA) Code Matrix (Wisconsin), effective Q4 2021
Molina Healthcare, Inc. (national grid)Molina national (MHI) Medicare gridAllprior auth requiredOct 1, 2021Medicare Prior Auth (PA) Code Matrix (national), effective Q4 2021

Payer coverage policies that name J9098

J9098 appears in 18 coverage policies from Aetna, BlueCross BlueShield of South Carolina.

PayerPolicyRole in policyReviewedDocument
AetnaAntiemetic Therapy (0724)listed, no stanceJul 17, 2026payer document
AetnaHematopoietic Cell Transplantation for Hodgkin's Disease (0495)listed, no stance (range J9000-J9999)Jul 2, 2026payer document
AetnaHematopoietic Cell Transplantation for Multiple Myeloma (0497)listed, no stance (range J9000-J9999)Aug 5, 2026payer document
AetnaHematopoietic Cell Transplantation for Selected Childhood Solid Tumors (0496)listed, no stance (range J9000-J9999)Aug 6, 2026payer document
AetnaHematopoietic Cell Transplantation for Thalassemia Major and Sickle Cell Anemia (0626)listed, no stance (range J9000-J9999)Sep 18, 2026payer document
AetnaInfusion Pumps (0161)covered if criteria are met (range J9000-J9999)Mar 31, 2026payer document
AetnaInjectable Medications (0020)listed, no stance (range J9000-J9999)Mar 5, 2026payer document
AetnaInotuzumab Ozogamicin (Besponsa) (0919)listed, no stanceJan 27, 2026payer document
AetnaMargetuximab-cmkb (Margenza) (0985)listed, no stance (range J9000-J9999)May 27, 2026payer document
AetnaNegative Pressure Wound Therapy (0334)listed, no stance (range J9000-J9999)Jun 8, 2026payer document
AetnaPertuzumab Products (0973)listed, no stance (range J9000-J9999)Apr 27, 2026payer document
AetnaPhototherapy and Photochemotherapy (PUVA) for Skin Conditions (0205)listed, no stance (range J9000-J9999)May 18, 2026payer document
AetnaRevakinagene Taroretcel-lwey (Encelto) (1079)listed, no stance (range J8501-J9999)Oct 5, 2026payer document
AetnaTumor Chemoresistance Assays (0758)listed, no stance (range J9000-J9999)Dec 2, 2025payer document
AetnaTumor Chemosensitivity Assays (0245)listed, no stance (range J9000-J9999)Apr 13, 2026payer document
BlueCross BlueShield of South CarolinaHematopoietic Cell Transplantation for Breast Cancer (CAM 80127)listed, no stance (range J9000-J9999)Jul 1, 2026payer document
BlueCross BlueShield of South CarolinaHematopoietic Cell Transplantation for Miscellaneous Solid Tumors in Adults (CAM 80124)unproven / investigational (range J9000-J9999)Jul 1, 2026payer document
BlueCross BlueShield of South CarolinaHematopoietic Stem-Cell Transplantation for Plasma Cell Dyscrasias, Including Multiple Myeloma and POEMS Syndrome (CAM 80117)listed, no stance (range J9000-J9999)Jan 1, 2026payer document

Recent prior-auth changes

  • Aug 1, 2026: PA removed, Molina Healthcare of Texas
  • Aug 1, 2026: PA added, HealthSpring
  • Apr 1, 2026: PA removed, UnitedHealthcare
  • Apr 1, 2026: PA removed, HealthSpring
  • Apr 1, 2026: PA removed, uhc:pa:summary-of-changes
  • Apr 1, 2026: PA removed, UnitedHealthcare
  • Mar 1, 2026: PA removed, UnitedHealthcare Community Plan
  • Feb 1, 2026: PA removed, UnitedHealthcare Community Plan
  • Feb 1, 2026: PA removed, UnitedHealthcare Community Plan
  • Feb 1, 2026: PA removed, uhc:pa:summary-of-changes

Medicaid fee-for-service

  • KY: $0.00 (asc), effective Jan 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.