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Ravulizumab-cwvz (Ultomiris) Procedure Code J1303 to be a Benefit of the CSHCN Services Program

Last updated on 5/29/2020

Effective for dates of service on or after June 1, 2020, Ravulizumab-cwvz (Ultomiris) procedure code J1303 will be a benefit of the Children with Special Health Care Needs (CSHCN) Services Program for clients who are 18 years of age and older.

Procedure code J1303 will be restricted to diagnosis code D593.

Procedure code J1303 may be reimbursed to physician assistant (PA), advanced practice registered nurse (APRN), and physician providers in the office setting, and hospital providers in the outpatient hospital setting.

For more information, call the TMHP-CSHCN Services Program Contact Center at 800-568-2413.