Ilaris® (canakinumab)

Authorization forms

Traditional, Optimized & Medicaid (11/2018) 

Medicare Part D (11/2018)

No prior authorization required if billed under Medicare Part B

No prior authorization required for:

  • Emergency room
  • Inpatient
  • Skilled nursing facility

For further information, please see the Injectable Drugs page

Code(s): J0638

Benefit: Medical

Notes:

  • Treatment of Familial Cold Autoinflammatory Syndrome (FCAS) and Muckle-Wells Syndrome (MWS)
  • C-code billable by facility only