Medica policies
Search Medica's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.
3 policies name J3490, those listing the fewest codes first. A policy that names a code may also list it as excluded.
| Policy | Details | Codes | Source |
|---|---|---|---|
| Intravenous, Intramuscular, and Subcutaneous Ketamine for Chronic Pain, Mental Health and Substance Use Disorders | Effective Sep 1, 2026 · Commercial, Medicaid | 1 | Original policy ↗ |
| Supply | RP-P-385X · Effective Nov 14, 2010 · Commercial, Medicaid | 3 | Original policy ↗ |
| New-to-Market Medical Pharmacy Products | Effective Nov 1, 2025 · Commercial, Medicaid | 6 | Original policy ↗ |