Rheumatology reimbursement alerts

Ustekinumab (BLA 761044), approved by Janssen Biotech as a new injectable dosage form, follows the Part B billing pathway given its injectable route of administration. As an established biologic inter

Benlysta (belimumab) is an injectable B Lymphocyte Stimulator-specific Inhibitor approved for systemic lupus erythematosus, administered via injection and billed under Medicare Part B. As a physician-

Benlysta (belimumab) received approval for a new injectable dosage form under BLA761043, expanding on its existing intravenous formulation with a subcutaneous injection route that supports Part B bill

YESINTEK (ustekinumab) is a biosimilar to Stelara, approved as an injectable administered by injection, placing it on the Medicare Part B billing pathway. As a biosimilar, it will likely be reimbursed

Saphnelo (anifrolumab-fnia) is an injectable Type I Interferon Receptor Antagonist approved for systemic lupus erythematosus, administered via intravenous infusion and billed under Medicare Part B. As

Krystexxa (pegloticase) is an injectable, PEGylated uricase approved for chronic refractory gout and administered via intravenous infusion, placing it firmly in the Medicare Part B billing pathway und

TRUTAKNA (atacicept-vymj) received FDA approval on July 7, 2026 as a subcutaneous injectable, which supports a Part B billing pathway for physician-administered drugs. As a new molecular entity withou

Xeljanz (tofacitinib) is an oral tablet approved under NDA203214, placing it squarely in the Medicare Part D billing pathway as a self-administered drug. Because it is dispensed via retail or specialt

Xeljanz XR (tofacitinib) is an oral extended-release tablet approved as a new dosage form of the already-marketed Xeljanz, placing it squarely in the Medicare Part D billing pathway. As an oral self-a

Rinvoq (upadacitinib) is an oral extended-release tablet approved as a new molecular entity, placing it squarely in the Medicare Part D billing pathway rather than Part B. As a self-administered oral

Xeljanz (tofacitinib) oral solution received FDA approval as a new dosage form under NDA213082, expanding on the existing tablet formulations already on the market. As an oral drug, this approval foll

Olumiant (baricitinib) is an oral Janus Kinase (JAK) inhibitor approved as a new molecular entity, billing under Medicare Part D as a self-administered tablet. As an oral outpatient medication, it doe

This approval represents a new oral solution dosage form of upadacitinib (RINVOQ), a Janus Kinase Inhibitor, under NDA218347. As an oral formulation, this drug follows the Part D billing pathway, cons

This newly approved drug, EXDENSUR (Depemokimab), has a confirmed route of administration as subcutaneous injection, allowing billing teams to categorize it under Part B. As it aligns with injectable

The MolDX policy for molecular biomarker testing could significantly impact reimbursement for targeted therapy selection in Rheumatoid Arthritis. As this policy becomes effective, providers may need t

The implementation of the MolDX guidelines for molecular biomarker testing in rheumatoid arthritis could significantly affect billing processes related to targeted therapy. Providers will need to ensu

The new LCD for Molecular Biomarker Testing in Rheumatoid Arthritis may expand the coverage for specific biomarkers, improving the choice of targeted therapies. This change will allow practices to bil

The implementation of the MolDX guidelines for molecular biomarker testing in rheumatoid arthritis will ensure more precise targeting of therapies and could enhance treatment outcomes. As these guidel