Q9995 Inj., emicizumab-kxwh 0.5 mg

Payer policies and prior authorization for Q9995

Medicaid fee-for-service

Prior authorization required or conditional in VA.

• WY: $0.00 (professional), effective Jan 1, 2019

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.