Medical Drug Benefit (J Code)

A prior authorization must be obtained from Magellan Rx before medical pharmacy (J-code) services are provided by practitioners in physician offices, outpatient facilities, and home infusion centers for the prior authorized Healthcare Common Procedure Coding System (HCPCS) codes. Requests can be made via the Magellan Rx portal or by calling 800-424-8241. Retrospective requests will not be reviewed. Magellan Rx offers peer-to-peer discussions for providers prior to any adverse determination. Utilize this process to provide information for evaluation of a request.


Page Last Updated: 09/23/2019