Prior Authorization Update: Lupron (Leuprolide)
Effective August 11, 2026, the codes below will not require prior authorization when billed with a cancer diagnosis. For all other diagnoses, prior authorization will be required for all providers.
- J1950 - Injection, leuprolide acetate (for depot suspension), per 3.75 mg
- J1951 - Injection, leuprolide acetate for depot suspension (Fensolvi), 0.25mg
- J1952 - Leuprolide injectable, Camcevi, 1mg
- J1954 - Injection, leuprolide acetate for depot suspension (Cipla), 7.5mg
- J9003 - Leuprolide injectable (Camcevi ETM), 1mg
- J9217 - Leuprolide acetate (for depot suspension), 7.5 mg
- J9219 - Leuprolide acetate implant, 65 mg
Prior authorization requirements can be looked up in the Medicaid Pre-Authorization Look-up Tool.