TL;DR: Aetna, a CVS Health company, modified CPB 1002 — its coverage policy for efgartigimod alfa-fcab (Vyvgart) and efgartigimod alfa and hyaluronidase-qvfc (Vyvgart Hytrulo) — effective December 10, 2025. Here's what billing teams need to know before submitting claims under HCPCS J9332 and J9334.

Aetna's updated Vyvgart coverage policy tightens medical necessity criteria for two approved indications: generalized myasthenia gravis (gMG) and chronic inflammatory demyelinating polyneuropathy (CIDP). The primary billing codes are J9332 (efgartigimod alfa-fcab, 2 mg) and J9334 (efgartigimod alfa and hyaluronidase-qvfc, 2 mg). Both require precertification, and the CIDP indication for Vyvgart Hytrulo carries an additional site-of-care utilization management requirement. If your practice bills either of these drugs to Aetna commercial plans, this update changes how you document and submit.


Quick-Reference Table

Field Detail
Payer Aetna, a CVS Health company
Policy Efgartigimod Alfa-fcab (Vyvgart) and Efgartigimod Alfa and Hyaluronidase-qvfc (Vyvgart Hytrulo)
Policy Code CPB 1002
Change Type Modified
Effective Date December 10, 2025
Impact Level High
Specialties Affected Neurology, Infusion Centers, Specialty Pharmacy
Key Action Verify AChR antibody status and step therapy documentation before submitting precertification for J9332 or J9334

Aetna Vyvgart Coverage Criteria and Medical Necessity Requirements 2025

The Aetna Vyvgart coverage policy under CPB 1002 covers two drugs for two indications. The rules are different for each combination. Get this wrong, and you'll get a claim denial before the drug even ships.

Generalized Myasthenia Gravis (gMG)

Aetna considers J9332 (Vyvgart IV) or J9334 (Vyvgart Hytrulo subcutaneous) medically necessary for gMG when all of the following are met:

#Covered Indication
1The member is anti-acetylcholine receptor (AChR) antibody positive
2MGFA clinical classification is II through IV
3MG activities of daily living (MG-ADL) total score is ≥ 5
+ 3 more indications

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  • The drug will not be used in combination with another neonatal Fc receptor (FcRn) blocker (e.g., Rystiggo) or complement inhibitor (e.g., Soliris, Ultomiris, Zilbrysq)
  • That AChR antibody requirement is the gate. If the chart doesn't document antibody-positive status, the prior authorization will be denied. Pull the lab results before you submit — not after.

    The combination exclusion is the other hard stop. Aetna will not cover Vyvgart alongside Rystiggo or complement inhibitors like eculizumab (J1300/Soliris) or ravulizumab (Ultomiris). If a patient is on any of those agents, you'll need to document a transition plan or the prior auth will fail.

    Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

    For CIDP, only Vyvgart Hytrulo (J9334) is covered — not the IV formulation (J9332). Aetna considers it medically necessary when all of the following are met:

    #Covered Indication
    1Disease course is progressive or relapsing/remitting for 2 months or longer
    2Diagnosis confirmed by electrodiagnostic testing consistent with EFNS/PNS guidelines — this means nerve conduction studies (CPT 95907–95913) and/or needle EMG (CPT 95860–95872) are in the chart
    3Step therapy satisfied — one of:
      Inadequate response or intolerable adverse event to immunoglobulins, corticosteroids, or plasma exchange
    + 1 more indications

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    The electrodiagnostic testing requirement is specific. Aetna explicitly references EFNS/PNS guidelines. Nerve conduction studies and needle EMG aren't optional supporting documentation here — they're required for the diagnosis to count. If the neurologist ordered only range-of-motion measurements (CPT 95851, 95852), that's not sufficient.

    CIDP also carries a site-of-care utilization management requirement under Aetna's drug infusion site-of-care policy. For Vyvgart Hytrulo in CIDP, Aetna will review where the drug is being administered. Infusion centers and hospital outpatient departments should expect scrutiny. Home administration or lower-cost sites may be preferred.

    Prior Authorization Requirements

    Both drugs require precertification for all Aetna participating providers and members in applicable plan designs. Call (866) 752-7021 or fax (888) 267-3277. Submit the Statement of Medical Necessity form through Aetna's Specialty Pharmacy Precertification portal before administering either drug.

    There's no grace period here. Administering either drug before prior authorization is approved puts full reimbursement at risk.


    Aetna Vyvgart Exclusions and Non-Covered Indications

    Aetna considers all indications for Vyvgart and Vyvgart Hytrulo experimental, investigational, or unproven except gMG and CIDP. That's a short list of covered uses for two drugs with expanding clinical trial programs.

    If you're billing J9332 or J9334 for anything other than gMG or CIDP — Lambert-Eaton myasthenic syndrome, pemphigus vulgaris, immune thrombocytopenia, or any other off-label use — Aetna will deny it under CPB 1002. Don't submit without a documented peer-to-peer plan or an appeals strategy ready.


    Coverage Indications at a Glance

    Indication Drug Covered Status Key Codes Notes
    Generalized myasthenia gravis (gMG) Vyvgart IV or Vyvgart Hytrulo Covered J9332, J9334 AChR antibody positive required; MG-ADL ≥ 5; MGFA Class II–IV; step therapy required; no combo with FcRn blockers or complement inhibitors
    Chronic inflammatory demyelinating polyneuropathy (CIDP) Vyvgart Hytrulo only Covered J9334 Electrodiagnostic confirmation required; step therapy required; site-of-care UM applies
    All other indications Either drug Not Covered J9332, J9334 Considered experimental, investigational, or unproven

    This policy is now in effect (since 2025-12-10). Verify your claims match the updated criteria above.

    Aetna Vyvgart Billing Guidelines and Action Items 2025

    The effective date for this modified coverage policy is December 10, 2025. If you're already billing J9332 or J9334, these actions are overdue. If you're about to start, do these before the first claim goes out.

    #Action Item
    1

    Confirm AChR antibody documentation for every gMG patient. Aetna's coverage policy is explicit: antibody-negative or antibody-unknown patients don't qualify. Pull the lab report and attach it to the prior authorization submission. Don't assume the ordering neurologist's notes are enough.

    2

    Audit step therapy records before submitting precertification. For gMG, you need 12 months of documented therapy with at least two immunosuppressives, or one immunosuppressive plus IVIG, or a clinical contraindication to both. For CIDP, you need documented failure or contraindication for immunoglobulins, corticosteroids, or plasma exchange. If those records aren't in the chart, the PA will be denied.

    3

    Verify electrodiagnostic testing for every CIDP patient. Nerve conduction studies (CPT 95907–95913) and needle EMG (CPT 95860–95872, 95885–95887) must be in the record and must meet EFNS/PNS diagnostic guidelines. If the neurologist's workup is incomplete, the prior auth request will fail at review.

    + 4 more action items

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    If you're managing a high-volume neurology or infusion practice with significant Aetna commercial exposure on these drugs, loop in your billing consultant or compliance officer before December 10, 2025 to review your existing authorizations under the modified criteria.


    Sample Version Diff Line-by-line changes
    Previous VersionCurrent Version
    Coverage is considered experimental and investigational for all indicationsCoverage is considered medically necessary when specific criteria are met
    Prior authorization is not requiredPrior authorization is required for initial treatment
    Documentation must include clinical historyDocumentation must include clinical history
    + 1 more action items

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    CPT, HCPCS, and ICD-10 Codes for Vyvgart Under CPB 1002

    HCPCS Codes Covered When Selection Criteria Are Met

    Code Type Description
    J9332 HCPCS Injection, efgartigimod alfa-fcab, 2 mg (Vyvgart IV)
    J9334 HCPCS Injection, efgartigimod alfa and hyaluronidase-qvfc, 2 mg (Vyvgart Hytrulo)

    CPT Codes Related to This Policy

    These codes appear in CPB 1002 as supporting procedures — diagnostic testing, infusion administration, and related services. They establish medical necessity documentation and support the clinical record for prior authorization and claim submission.

    Code Type Description
    36514 CPT Therapeutic apheresis; for plasma pheresis
    90283 CPT Immune globulin (IgIV), human, for intravenous use
    95851 CPT Range of motion measurements and report; each extremity (excluding hand)
    + 32 more codes

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    Selected HCPCS Codes Referenced in CPB 1002 (Comparator and Related Drugs)

    These HCPCS codes appear in CPB 1002 as reference codes for drugs mentioned in the criteria — including excluded combination drugs and step therapy agents.

    Code Type Description
    J0702 HCPCS Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
    J1094 HCPCS Injection, dexamethasone acetate, 1 mg
    J1100 HCPCS Injection, dexamethasone sodium phosphate, 1 mg
    + 2 more codes

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    The full HCPCS code list in CPB 1002 includes 162 codes. The codes above are the primary billing and reference codes most relevant to Vyvgart billing.

    Note: No ICD-10-CM codes are listed in the CPB 1002 policy data. Document the clinical diagnosis using the appropriate ICD-10 code for gMG or CIDP based on your standard coding workflow.


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