Lemtrada

Drug - Lemtrada® (alemtuzumab) [Genzyme Corporation]li Lilly]

October 2015

Therapeutic area - Multiple Sclerosis

Criteria

• Patient must have a diagnosis of a relapsing form of multiple sclerosis AND
• Patient has a history of 2 prior treatments with 2 unique multiple sclerosis therapies

Billing

As of October 1, 2015, Lemtrada should be billed using HCPCS code Q9979.

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411