| HCPCS | Generic Name | Brand Name | Strength | SEER*Rx Category | Major Drug Class | Minor Drug Class | Oral (Y/N) | FDA Approval Year | FDA Discontinuation Year | CMS Effective Date | CMS Discontinuation Date | Status |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Maribavir | Livtencity | 200mg | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Yes | 2021 | In Use | ||||
| J2425 | Palifermin | Kepivance | 50 mcg | Ancillary Therapy | Epithelial Growth Factor | Keratinocyte Growth Factor/rHuKGF | No | 2004 | Jan 1, 2006 | In Use | ||
| J1456 | Fosaprepitant (Teva) | Fosaprepitant (Teva) | 1mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | No | 2019 | Dec 21, 2022 | In Use | ||
| J0641 | Levoleucovorin | Fusilev, Levoleucovorin | 0.5 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2008 | Oct 1, 2019 | In Use | ||
| Q5171 | Denosumab (boncres) | Boncresa | 1mg | Ancillary Therapy | Monoclonal Antibody | RANKL | No | 2025 | Jun 17, 2026 | In Use | ||
| J8655 | Netupitant/Palonosetron | Akynzeo | 300mg/0.5 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Anatagonist, Substance P/Neurokinin 1 | Yes | 2014 | Jan 1, 2016 | In Use | ||
| Q5125 | Filgrastim | Releuko | 1mcg | Ancillary Therapy | Immunostimulant | Granulocyte colony stimulating factor | No | 2022 | Sep 27, 2022 | In Use | ||
| J1436 | Etidronate Disodium | Didronel | 300 mg | Ancillary Therapy | Bisphosphonate | No | 1977 | Jan 1, 1990 | In Use | |||
| J1627 | Granisetron Hydrochloride Extended Release | Granisol [DSC], Sancuso, Sustol, Kytril | 0.1 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 2016 | Jan 1, 2018 | In Use | ||
| NA | Cyclosporine | NeOral | 25mg, 100mg | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Yes | 1995 | In Use | |||
| C9428 | Mesna | Mesna rescue, Mesnex, Mesna Novaplus, Uromitexan | 200 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1988 | Jan 1, 2004 | Dec 31, 2005 | No Longer Used | |
| J9209 | Mesna | Mesna rescue, Mesnex, Mesna Novaplus, Uromitexan | 200 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1988 | Jan 1, 1990 | In Use | ||
| NA | Metoclopramide | Reglan | 5mg, 10mg | Ancillary Therapy | Antiemetic | Dopamine-2 Receptor Antagonist | Yes | 1991 | In Use | |||
| C9448 | Netupitant/Palonosetron | Akynzeo | 300mg/0.5 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 | Yes | 2014 | Apr 1, 2015 | Jun 30, 2015 | No Longer Used | |
| NA | Cervarix | Human papillomavirus vaccine | 20 mcg vaccine | Ancillary Therapy | Protective Agent | HPV Vaccine | No | 2009 | 2016 | In Use | ||
| J1190 | Dexrazoxane | Zinecard | 250 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1995 | Jan 1, 2007 | In Use | ||
| NA | Aprepitant | Emend | 80 mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Yes | 2003 | In Use | |||
| Q0168 | Dronabinol | Marinol | 5 mg | Ancillary Therapy | Antiemetic | CB1/CB2 | Yes | 1985 | Apr 1, 1998 | In Use | ||
| Q0166 | Granisetron Hydrochloride | Granisol [DSC], Sancuso, Sustol, Kytril | 1 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1993 | Jan 1, 2009 | In Use | ||
| J0207 | Amifostine | Ethyol | 500 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1995 | Jan 1, 1998 | In Use | ||
| Q5120 | Pegfilgratim-bmez | Ziextenzo | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony Stimulating Factor | No | 2019 | Jul 1, 2020 | In Use | ||
| NA | Anagrelide | Agrylin | 0.5mg | Ancillary Therapy | Platelet-Reducing Agent | PDE-3 Inhibitor | Yes | 1997 | In Use | |||
| C9145 | Aprepitant | Aponvie | 1mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | No | 2023 | Mar 17, 2023 | Mar 18, 2026 | In Use | |
| J8501 | Aprepitant | Emend | 5 mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Yes | 2003 | Jan 1, 2005 | In Use | ||
| J2469 | Palonosetron | Aloxi | 25 mcg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 2003 | Jan 1, 2005 | In Use |
The use of NA indicates that the HCPCS code was Not Available. NA may mean that a) the HCPCS code has
not yet been created (new drug), b) the drug is given as an oral drug or alternative route (only in
specific instances are HCPCS assigned to these medications), or c) the HCPCS could not be found or is
truly not available.
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