Antiretroviral Ibalizumab-uiyk Injection Available for Managed Care Plans

May 20, 2022

Effective retroactively for dates of service on or after March 6, 2018, HCPCS code J1746 (injection, ibalizumab-uiyk, 10 mcg) is a noncapitated service for Managed Care Plans (MCPs) except for the following Health Care Plans (HCPs):

  • Cal MediConnect

  • Program of All-Inclusive Care for the Elderly (PACE)

  • Senior Care Action Network (SCAN)

  • Health Plan of San Mateo

  • CalOptima

HCPCS code J1746 is used to treat multidrug resistant HIV-1 in heavily treatment-experienced adults failing their current antiretroviral regimen.

lbalizumab-uiyk was available as a noncapitated·service for AIDS Healthcare Centers - Los Angeles for dates of service from March 6, 2018, to June 30, 2019.

Providers are encouraged to check the Medi-Cal website regularly for updates to the current list of contract drugs and MCP policy.