Kadcyla (ado-trastuzumab emtansine)

Authorization forms

Traditional, Optimized. & Medicaid (05/2019)

Medicare Part D (05/2019)

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): J9354

Benefit: Medical

Notes: Treatment of metastatic breast cancer