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The Bridge Program

Learn how the Bridge Program applies to NYCE PPO, Large Group, and ASO plan members in 2026.

Pluvicto™ Added To Preauthorization List August 1, 2022

Our Preauthorization List has been updated to include Pluvicto™ (lutetium Lu 177 vipivotide tetraxetan); a new FDA approved radiopharmaceutical used for treatment of progressive, prostate-specific membrane antigen (PSMA) positive, metastatic castration-resistant prostate cancer.

New Codes Requiring Preauthorization Starting August 1, 2022

CPT/HCPCS Code CPT/HCPCS Code Description
A9699 (Radiopharmaceutical, therapeutic, not otherwise classified)
Temporary Code through 9/30/2022 (see A9607 effect 10/01/2022)
A9607 Pluvicto™ (Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie)
Replacement Code for A9699 - effective 10/01/2022



 

JP 56610

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