Injectable physician-administered products are typically covered under the medical or Part B benefit, though some payers may require coverage under the pharmacy or Part D benefit. Coverage details can be determined during the benefits verification process.
The reimbursement rates of injectable physician-administered drugs covered under the medical or Part B benefit may depend on site of care, payer, and drug-specific information.
Regularly review insurance provider payments to the office and reconcile reimbursement of both primary and secondary insurance providers.
For questions about CIMERLI® reimbursement, call Coherus Solutions™ at
1-844-483-3692 or visit the Coherus Solutions™ Provider Portal.
Participating patients, pharmacies, physician offices and hospitals may use Coherus’ patient services web portal or send completed enrollment forms to 1-877-226-6370 to enroll patients. Under the program, if a patient incurs a co-pay obligation for the administration of CIMERLI, and meets all eligibility requirements, Coherus shall subsidize the cost of administration up-to $1000 per calendar year. The program benefit will reset every January 1st. Re-enrollment in the program is required at regular intervals. Patients may participate in the program as long as patient re-enrolls as required by Coherus BioSciences and continues to meet all of the program’s eligibility requirements during participation in the program.. After reaching the maximum program benefit, the patient will be responsible for all remaining out-of-pocket expenses. The amount of the program’s benefits cannot exceed the patient’s out-of-pocket expenses for the cost of the drug or administration fees associated with CIMERLI.