For US Healthcare Professionals Only

YUPELRI® (revefenacin) inhalation solution
coverage and reimbursement

J-CODE and NDC number for prescribing YUPELRI

For Your Patients with Medicare*

YUPELRI is expected to be covered for up to 100% of patients with Medicare Part B*.

  • For patients with supplemental insurance (over 80% of beneficiaries), coinsurance costs can be as low as $0*
  • Medicare Part B covers most nebulizers as durable medical equipment (DME) for patient use at home

Get Your Patients Started >>

J-CODE and NDC number for prescribing YUPELRI

* 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.

YUPELRI Patient Savings Card for patients with commercial coverage

For Your Patients with Commercial Coverage

YUPELRI may be covered under individual insurance plans.

  • Eligible, commercially insured patients may pay as little as $0 per prescription for up to 12 months, with a maximum benefit of $6,600 per year with the YUPELRI Savings Card.
  • Certain restrictions apply. See full Terms and Conditions for YUPELRI Savings Card. This offer is not valid for patients covered by Medicare, Medicaid or any other federal or state funded healthcare program or where prohibited by law. Mylan Specialty L.P. reserves the right to amend or end this program at any time without notice.

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Get Your Medicare Part B Patients Started Today

Be Sure to Use the Appropriate Codes§
ICD-10 COPD Code Permanent J-CODE YUPELRI NDC No.
J41-44.9§ J7677 49502-0806-93

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:

1 A prescription for YUPELRI

Specify:

  • Dosing instructions
  • “Via standard jet nebulizer”
  • Quantity to be dispensed
  • Number of refills
  • Permanent J-CODE
  • ICD-10 code
YUPELRI (revefenacin) prescription form

2 A prescription for the standard jet nebulizer

Specify:

  • Compressor
  • Administration set
  • ICD-10 code: J41-44.9§

For more information on ICD-10 codes, click here.

3 Detailed written order20

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
YUPELRI Savings Card

Indication

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YUPELRI® inhalation solution is indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD).

Important Safety Information

YUPELRI is contraindicated in patients with hypersensitivity to revefenacin or any component of this product.

YUPELRI should not be initiated in patients during acutely deteriorating or potentially life-threatening episodes of COPD, or for the relief of acute symptoms, i.e., as rescue therapy for the treatment of acute episodes of bronchospasm. Acute symptoms should be treated with an inhaled short-acting beta2-agonist.

YUPELRI® inhalation solution is indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD).

Important Safety Information

YUPELRI is contraindicated in patients with hypersensitivity to revefenacin or any component of this product.

YUPELRI should not be initiated in patients during acutely deteriorating or potentially life-threatening episodes of COPD, or for the relief of acute symptoms, i.e., as rescue therapy for the treatment of acute episodes of bronchospasm. Acute symptoms should be treated with an inhaled short-acting beta2-agonist.

As with other inhaled medicines, YUPELRI can produce paradoxical bronchospasm that may be life-threatening. If paradoxical bronchospasm occurs following dosing with YUPELRI, it should be treated immediately with an inhaled, short-acting bronchodilator. YUPELRI should be discontinued immediately and alternative therapy should be instituted.

YUPELRI should be used with caution in patients with narrow-angle glaucoma. Patients should be instructed to immediately consult their healthcare provider if they develop any signs and symptoms of acute narrow-angle glaucoma, including eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema.

Worsening of urinary retention may occur. Use with caution in patients with prostatic hyperplasia or bladder-neck obstruction and instruct patients to contact a healthcare provider immediately if symptoms occur.

Immediate hypersensitivity reactions may occur after administration of YUPELRI. If a reaction occurs, YUPELRI should be stopped at once and alternative treatments considered.

The most common adverse reactions occurring in clinical trials at an incidence greater than or equal to 2% in the YUPELRI group, and higher than placebo, included cough, nasopharyngitis, upper respiratory infection, headache and back pain.

Coadministration of anticholinergic medicines or OATP1B1 and OATP1B3 inhibitors with YUPELRI is not recommended.

YUPELRI is not recommended in patients with any degree of hepatic impairment.

For additional information please contact us at 800-395-3376.

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