Pylarify Reimbursement. PYLARIFY ® (piflufolastat F 18) injection (also known as 18 F

PYLARIFY ® (piflufolastat F 18) injection (also known as 18 F-DCFPyL or PyL) is a fluorinated small molecule PSMA-targeted PET imaging agent that enables visualization of Laws and regulations regarding reimbursement change frequently and providers are solely responsible for all decisions related to coding and billing including determining, if and under PYLARIFY (piflufolastat F 18) is a PSMA-targeted PET imaging agent for prostate cancer. Understand pricing, insurance coverage, and financial The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule for the 2026 Outpatient Prospective Payment System (OPPS), indicating that there will CODING AND BILLING GUIDE For important risk and use information about PYLARIFY® Injection, please see Important Safety Information on page 6 and Full Prescribing Information Lantheus Holdings' PYLARIFY maintains market leadership as CMS announces new unbundled payment rates for diagnostic radiopharmaceuticals, effective January 2025. Pricing strategies balance profitability Pylarify is a PSMA-targeted PET agent for pinpointing suspected metastasis or recurrence of prostate cancer, which will be impacted by a new Medicare policy change. 11, 2023, the Indiana Health Coverage Programs (IHCP) will remove prior authorization (PA) requirements for Pylarify, a radiodiagnostic agent indicated for positron This resource highlights product, procedure, and diagnosis coding information relevant to the use of PYLARIFY® (piflufolastat F 18) Injection PET/CT that may be applicable for billing purposes. A 116% jump in R&D spending and $950M+ PYLARIFY CODING AND BILLING GUIDE | PYLARIFY Reimbursement Hotline: 844-339-8514 PYLARIFY and the associated services provided PYLARIFY® (piflufolastat F 18) Injection is a radioactive diagnostic agent indicated for positron emission tomography (PET) of prostate- specific membrane antigen (PSMA) positive lesions in Lantheus faces an 8. Find the support to order PYLARIFY for PSMA-targeted PET scans, including cost reimbursement, Medicare and insurance coverage, and billing and Review description and fee schedules for HCPCS Code A9595 (Pylarify), intended for Administrative, Miscellaneous and Investigational, and The performance of PYLARIFY for imaging of metastatic pelvic lymph nodes prior to initial definitive therapy seems to be affected by risk factors such as Gleason score and Find out how much is pylarify (piflufolastat F 18), the diagnostic agent used in PSMA PET scans for prostate cancer. See indications and learn how PYLARIFY performs at Lantheus Continues to Commend CMS’ CY25 Rule to Enhance Payment for Specialized Diagnostic Radiopharmaceuticals and Reaffirms Outlook for PYLARIFY’s Lantheus Holdings' PYLARIFY sales surged 24% to $1. 1 billion, but faces pricing pressure post-TPT and increased competition. With PYLARIFY ® (piflufolastat F 18) on track to exceed $1 billion in sales in 2024, Lantheus reaffirms its 2025 outlook for PYLARIFY as a blockbuster brand that will continue to Effective Dec. [1][4][5] It is given by intravenous Watch real patient stories, explore available patient brochures, find questions to ask your doctor, and more resources here with PYLARIFY® PYLARIFY coding AND BILLING GUIDE | PYLARIFY Reimbursement Hotline: 844-339-8514 PYLARIFY and the associated services provided in a physician office are billed on the CMS Pylarify (also known as piflufolastat F 18 injection) is a fluorine 18-based prostate-specific membrane antigen (PSMA)-targeted positron emission tomography (PET) imaging agent that 2. Have questions or need support? Contact us for assistance and information on the imaging capabilities of PYLARIFY. Based on the intensity of the signals, PET images obtained using PYLARIFY indicate PYLARIFY's inclusion in LCDs (Local Coverage Determinations) and coding updates have improved reimbursement pathways ( [5]). . 3% quarterly revenue decline for its key product, PYLARIFY, due to expired reimbursement status, prompting a strategic pivot through $670 million in new Pylarify, Gallium 68 PSMA-11, and Posluma are radioactive diagnostic agents indicated for positron emission tomography (PET) of PYLARIFY ® (piflufolastat F 18) Injection is a radioactive diagnostic agent indicated for positron emission tomography (PET) of prostate-specific membrane antigen (PSMA) With PYLARIFY ® (piflufolastat F 18) on track to exceed $1 billion in sales in 2024, Lantheus reaffirms its 2025 outlook for PYLARIFY as a blockbuster brand that will continue to Pylarify was approved by the FDA in 2021 for use in prostate-specific membrane antigen (PSMA) positive lesions in men with prostate cancer who have suspected metastasis and are Piflufolastat (18F), sold under the brand name Pylarify among others, is a radioactive diagnostic agent used for positron emission tomography (PET) imaging. 5 Image Display and Interpretation PYLARIFY binds to prostate-specific membrane antigen (PSMA).

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