MedicaidPrior AuthLow impact
BT202198: IHCP updates PA criteria for HCPCS code Q2041 (Yescarta)
Indiana Medicaid (IHCP)·IN · Oncology, Hematology·Claims & Billing
Effective date
Jul 1, 2021
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) expanded prior authorization criteria for HCPCS code Q2041 (Yescarta CAR-T therapy) to include relapsed or refractory follicular lymphoma after two or more lines of systemic therapy. The treatment requires administration at REMS-certified facilities by qualified providers for patients 18 and older meeting specific diagnostic criteria.
Action Required
Billing team should update prior authorization documentation requirements for HCPCS Q2041 to include follicular lymphoma diagnosis criteria. Verify facility REMS certification and provider qualifications before submitting claims. Contact Gainwell Technologies at 800-457-4584, option 7 for Q2041 prior authorization questions.