FEP Update: Select Medications to Require Prior Authorization
Mon, Nov 24, 2025
The following medications will require prior authorization for Federal Employee Program (FEP) members, effective Feb. 1, 2026. As part of this change, medical necessity review will be modified from post-service to pre-service for these medications.
The codes below will appear on the Prior Authorization list for FEP on the Provider Resource Center effective Feb. 1, 2026:
HCPCs |
Drug Name |
J9023 |
Bavencio |
J9173 |
Imfinzi |
J9347 |
Imjudo |
J9271 |
Keytruda |
Jemperli |
|
NOC ** |
Keytruda Qlex |
J9119 |
Libtayo |
J9299 |
Opdivo |
J9298 |
Opdualag |
J9022 |
Tecentriq |
J9228 |
Yervoy |
J9345 |
Zynyz |
** NOC requires NDC submission
FEP Prior Authorization Lists
The list of the drugs that require prior authorization will be available Dec. 15, 2025, on the Provider Resource Center here.
Providers can submit prior authorization requests, under a member’s medical benefits, for the listed drugs via Availity Essentials.
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