J0717 prior authorization | Blue Cross and Blue Shield of Montana

J0717, Injection Certolizumab Pegol BCBSMT 1 Mg (Code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician Not For Use When Drug Is Self Administered), is on the Blue Cross and Blue Shield of Montana prior authorization list. Not a coverage or referral decision.

Code: J0717
Description: Injection Certolizumab Pegol BCBSMT 1 Mg (Code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician Not For Use When Drug Is Self Administered)
Source: 2026 Specialty Drugs and Infusion Site of Care Prior Authorization Code List, Pg 5 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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