September 18, 2025
Beginning with dates of service on or after April 1, 2025, Healthcare Common Procedure Coding System (HCPCS) code J1299 is required for the prior authorization of Soliris® in alignment with Centers for Medicare & Medicaid Services (CMS) guidelines. HCPCS code J1300 is no longer accepted. Soliris, a prescription IV infusion medication, is used to treat several rare autoimmune disorders.
How customers are affected
Customers with Cigna Healthcare® coverage who have existing prior authorizations with HCPCS code J1300 dated before April 1, 2025, will continue to be covered through the duration of the approved time frame under their medical benefit though Accredo® Specialty Pharmacy. Claims paid under their pharmacy benefits are not affected by this change. Providers do not need to take any action.
Providers can call Cigna Healthcare Provider Service at 800.88Cigna (882.4462) if they have any questions.
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