Passport Health Plan by Molina Healthcare policy
Provenge (sipuleucel-T)
Provenge (sipuleucel-T) is a public Passport Health Plan by Molina Healthcare policy. It lists 3 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
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- Line of business
- Commercial, Medicaid
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes.
| Code | Other Passport Health Plan by Molina Healthcare policies |
|---|---|
| 96413 | Policies naming 96413 |
| 96415 | Policies naming 96415 |
| Q2043 | Policies naming Q2043 |