Molina Healthcare of Kentucky policy
Roctavian (valoctocogene roxaparvovec)
Roctavian (valoctocogene roxaparvovec) is a public Molina Healthcare of Kentucky policy (effective Dec 14, 2025). It lists 3 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
Check eligibility for free
No account required. Sign a BAA to see plan details, coordination of benefits and more
- Effective
- Dec 14, 2025
- Line of business
- Medicaid
- States
- KY
- Source
- www.molinahealthcare.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.
| Code | Other Molina Healthcare of Kentucky policies |
|---|---|
| 96413 | Policies naming 96413 |
| 96415 | Policies naming 96415 |
| J1412 | Policies naming J1412 |
All Molina Healthcare of Kentucky policies · Molina Healthcare of Kentucky prior authorization CPT list