Orencia (Abatacept) Injection for Intravenous Infusion
Medical necessity and coverage criteria for Orencia (abatacept) administered by intravenous infusion for multiple immune-mediated indications, and who may prescribe or administer it under UnitedHealthcare commercial medical benefit plans.
Added language to clarify Orencia (abatacept) for self-administered subcutaneous injection is obtained under the pharmacy benefit, unless otherwise specified in the member's benefit plan documents; for members enrolled in UnitedHealthcare of California plans with a delegated provider group conducting the prior authorization review, the self-administered Orencia may be obtained under the medical benefit.
Updated list of applicable ICD-10 diagnosis codes to reflect annual edits; added M05.A.
Archived previous policy version 2025D0039U.
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