Comprehensive coverage for your YUPELRI patients

For your patients with Medicare*
YUPELRI is covered for up to 100% of patients with Medicare Part B.
- For patients with supplemental insurance (over 80% of beneficiaries), coinsurance costs may be as low as $0
- Medicare Part B covers most nebulizers as durable medical equipment (DME) for patient use at home19
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*This is not a guarantee of coverage. Site of care will determine coverage. Check with your patient’s insurance provider for coverage rules and restrictions. In certain limited instances YUPELRI may be covered through a patient’s Medicare Part D pharmacy benefit.

*This is not a guarantee of coverage. Site of care will determine coverage. Check with your patient’s insurance provider for coverage rules and restrictions. In certain limited instances YUPELRI may be covered through a patient’s Medicare Part D pharmacy benefit.

For your patients with commercial coverage
YUPELRI may be covered under individual insurance plans.
- Commercially insured patients may be eligible to save on their out-of-pocket costs with the YUPELRI Patient Savings Card†
- Eligible, commercially insured patients may save up to $550 per 30-day prescription up to 12 times per calendar year, with a max yearly savings of $6,600. Please see full terms and conditions
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Please find general information on Medicare Part B documentation requirements and coding below
This is general information on how to prepare claims for patients who have been prescribed YUPELRI. Each office remains responsible for properly submitting all claims for medically appropriate patients. Please refer to CMS regulations and guidance and applicable MAC documentation requirements.
Be sure to use the appropriate codes‡
ICD-10 COPD Code
- J41-44.9‡
J-CODE
- J7677
New patients who don’t already own a nebulizer will need 2 separate prescriptions and a detailed written order for Medicare Part B‡
When prescribing YUPELRI for patients new to nebulized therapy, include the following:
3Detailed written order19
Medicare requires a physician to document that a face-to-face evaluation with the patient, detailing the treatment and/or evaluation of a condition that supports the need for the nebulizer, occurred within the 6 months prior to the written order for a nebulizer.
‡Other codes may apply.
§DME suppliers may require additional documentation.

Remember to tell your commercially insured patients about the