Yorvipath (palopegteriparatide) prior authorization / medical necessity
UnitedHealthcare prior authorization and medical necessity criteria for Yorvipath (palopegteriparatide) for treatment of hypoparathyroidism in adults, including initial authorization, reauthorization, prescribing provider requirements, and program rules. Effective date governs utilization management for commercial pharmacy benefit.
New prior authorization program created for Yorvipath (palopegteriparatide) with P&T approval dated 12/2024 and effective date 3/1/2025.
Coverage Summary
Coverage stance: covered_with_criteria for Yorvipath (palopegteriparatide) prior authorization and medical necessity per policy number 2024 P 2358-1. Scope: UnitedHealthcare prior authorization and medical necessity criteria for treatment of hypoparathyroidism in adults under the commercial pharmacy benefit; effective date 2025-03-01.
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