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
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.