Complement Inhibitors
Defines coverage, preferred products, diagnosis-specific medical necessity criteria, continuation/initial authorization limits, excluded uses, and applicable HCPCS/J-codes and ICD-10 diagnoses for complement inhibitor products (eculizumab variants, ravulizumab, crovalimab) under Colorado Rocky Mountain Health Plans (part 1 of 2).
Revised coverage criteria for Generalized Myasthenia Gravis requiring patients not to receive the requested product in combination with B-cell depletion therapy or an immune globulin for the same indication.
Removed the initial therapy requirement for NMOSD that previously required a history of >=2 relapses in prior 12 months or >=3 relapses in prior 24 months with >=1 in past 12 months.
Removed content/language pertaining to the state of Louisiana (administrative jurisdiction change).
Archived previous policy version CS2026D0049AD.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.