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Texas MedicaidMedicaid · Coverage · Coding · TX · Dermatology, PediatricsLow impact

Age Restriction Update for Beremagene Geperpavec-Svdt (Vyjuvek) Procedure Code J3401

Effective date
Mar 1, 2026
Identified
Jan 24, 2026

Summary

Effective March 1, 2026, the FDA has approved age expansion for beremagene geperpavec-svdt (Vyjuvek) procedure code J3401 to include adult and pediatric clients of all ages, removing previous age restrictions. This change applies to Texas Medicaid and managed care organizations must provide this medically necessary service to enrolled members.

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What to do

Action · 3 steps
01Before March 1, 2026: Billing team must update system settings to remove age restrictions for HCPCS code J3401 (beremagene geperpavec-svdt/Vyjuvek).
02Contact specific Texas Medicaid MCOs to verify any administrative requirements like prior authorization or referrals, as these may vary by plan.
03Update encounter forms to reflect expanded age eligibility.

Codes mentioned

J3401

Original notice

Age Restriction Update for Beremagene Geperpavec-Svdt (Vyjuvek) Procedure Code J3401
tmhp.com · Always check the source before changing claims.
View original ↗

Related policy hubs

Texas Medicaid policiesTX policy changesDermatologyPediatricsCode J3401

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