Kineret® (anakinra)

No prior authorization required for:

  • Emergency room
  • Inpatient
  • Skilled nursing facility

Injectable auth/billing notes:

Medications billed with miscellaneous codes will be reviewed. Explanatory notes must accompany the claim.

Priority Health Medicare applies CMS local coverage determination criteria when available for Part B drugs.

Code(s): J3590, J9999

Benefit: Pharmacy only, must be purchased through a specialty pharmacy

Notes: For treatment of moderate to severe symptoms of rheumatoid arthritis

Length of initial authorization: 3 months

Length of continuation authorization: 12 months