Once a decision has been
made to prescribe IMAAVY™
Help your
patients start
and stay on IMAAVY™
The IMAAVY withMe program offers your eligible patients free access to resources, guidance, and personalized support throughout their treatment journey.
Enroll your patients nowResources for Healthcare Professionals
Click on each of the options to learn more
Tap on each of the options to learn more
Provider Portal
Access and Fulfillment
Coding and Reimbursement
Provider Portal
The Provider Portal offers a customizable patient dashboard with real-time status updates and 24-hour access to:
Enroll eligible patients in
IMAAVY withMe patient support offerings, including
Nurse Navigator,* Savings Program, and Access Program
Request benefits investigations and prior authorizations in
real time
Review the status of benefits investigations
View and help manage patients’ Savings Program benefits as requested by enrolled patients
Enroll eligible patients in the Johnson & Johnson Patient Assistance Program
Receive notifications when new information is available or action is required in the Portal
IMAAVY withMe offers access and fulfillment support along the way
For commercially insured patients who experience a delay or denial of coverage
- IMAAVY withMe Access Program offers eligible patients IMAAVY™ at no cost for up to 3 years or until their commercial insurance covers the medicine. See program requirements.
Get customized patient fulfillment support from a dedicated team that includes:
Case Manager Team
- A Case Manager who checks eligibility and can enroll patients in
IMAAVY withMe offerings
Field Reimbursement Manager (FRM)
- An FRM who provides in-office educational support
Together they can:
- Provide access and affordability support to help patients start and stay on treatment
- Get fulfillment status updates and help minimize delays
Enroll your patients in this comprehensive program via the Provider Portal.
We'll help educate your office on reimbursement, billing, and coding so you can focus on your patients
Johnson & Johnson is committed to providing you with information to help guide you through the reimbursement process for IMAAVY™. Support is available to help your patients get access to the treatment they need.
Coding and reimbursement support includes:
- In-office educational support from a Field Reimbursement Manager (FRM)
- Information about dosing and formulation
- Coding for IMAAVY™ and drug administration
- Claim submission education
- Sample claim forms and a filing checklist
National Drug Code (NDC)
Payer requirements for NDC use and format can vary widely. Refer to sample claims forms beginning on page 6 of the Billing and Coding Guide for additional information.
| FDA-Specified NDC | ||
|---|---|---|
| 10-digit NDC (5-3-2 format) | 11-digit NDC (5-4-2 format) | Description |
| 57894-801-01 | 57894-0801-01 | One single-dose vial containing 1200 mg (185 mg/mL) for intravenous injection |
ICD-10-CM Diagnosis Codes
The table below lists ICD-10 diagnosis codes that you may need for patients treated with IMAAVY™. These codes are not intended to be promotional or to suggest a use that is inconsistent with FDA-approved use. The list is not exhaustive and additional codes may apply.
| Myasthenia Gravis: ICD-10-CM Codes for Consideration | |
|---|---|
| G70.00 | Myansthenia gravis without (acute) exacerbation |
| G70.01 | Myasthenia gravis with (acute) exacerbation |
Drug HCPCS Codes
As a newly approved drug, IMAAVY™ does not yet have a unique HCPCS code. Miscellaneous/unclassified codes allow immediate billing as soon as the FDA allows it to be marketed, while awaiting assignment of a permanent code. Required reporting of miscellaneous drug codes can vary by site of care, payer, and timing after FDA approval.
Transition to Permanent HCPCS Code
Site of Care
Payer
Coding Following FDA Approval Up
to Assignment of a
Permanent HCPCS Code
Permanent
HCPCS Code
Physician
Office
All payers
J3490 - Unclassified drugs‡
J3590 - Unclassified biologics‡
Site of Care
Payer
Coding Immediately
Following FDA Approval
Anticipated October 1, 2025
Hospital
Outpatient
Department
Medicare
C9399 - Unclassified drugs
or biologics
Temporary,
drug-specific code
Non-Medicare§
J3490 - Unclassified drugs‡
J3590 - Unclassified biologics‡
Site of Care
Hospital Outpatient Department
Payer
Medicare
Non-Medicare§
Coding Immediately Following FDA Approval
C9399 - Unclassified drugs or biologics
J3490 - Unclassified drugs‡
J3590 - Unclassified biologics‡
Anticipated October 1, 2025
Temporary, drug-specific code
Permanent HCPCS Code
Anticipated January 1, 2026
‡As required by payer.
§Includes Medicare Advantage.
Medicare Payment Considerations for New Drugs
- The absence or presence of a HCPCS code, NDC code, or payment allowance limit in the files does not indicate whether Medicare covers a particular product.
- Even if a product does not appear on a quarter’s national price file, it may still be paid by the local contractor that processes the Part B claim, provided that the claim is reasonable and necessary and meets all necessary requirements for payment. In such a case, the local contractor will also determine the payment amount.
- Each Medicare Administrative Contractor (MAC) will make a local determination of wholesale acquisition cost (WAC) or invoice-based payment.
CPT® Codes for Drug Administration
Payer policies for codes that describe drug administration services may vary; contact your payer for their code requirements.
| CPT® Code | Descriptor |
|---|---|
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour |
| 96413 | Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug |
NOTE: An infusion of 15 minutes or less is an intravenous push.
Place of Service Codes
| Code | Place of Service |
|---|---|
| 11 | Office |
| 19 | Off campus – outpatient hospital |
| 22 | On campus – outpatient hosptial |
Revenue Codes
| Code | Descriptor |
|---|---|
| 0260 | IV (Intravenous) therapy, general |
| 0510 | Clinic, general |
| 0636 | Pharmacy, drugs requiring detailed coding |
NOTE: Many payers require this for HOPD claims.
HCPCS Modifiers
| Modifier | Code Description |
|---|---|
| JW | Drug amount discarded/not administered to any patient |
| JZ | No discarded drug amounts |
| TB | Drug or biological acquired with 340B pricing program discount, reported for informational purposes |
Collected in 03/25 and may change.
This information is not a promise of coverage or payment. It is not intended to give reimbursement advice or increase reimbursement by any payer. Legal requirements and plan information can be updated frequently. Contact the plan for more information about current coverage, reimbursement policies, restrictions, or requirements that may apply.
For more information on ICD-10, visit the CMS website.
Enroll your patients in IMAAVY withMe via the Provider Portal.
For billing and coding or reimbursement questions, or to schedule a meeting with a local Johnson & Johnson representative, call 844-4withMe (844-494-8463) or visit JNJwithMe.com/hcp/IMAAVY
Resources for Your Patients
Click on each of the options to learn more
Tap on each of the options to learn more
Access and
Affordability Support
Tailored Resources
Dedicated Nurse Navigator*
Commercial or Private Insurance
IMAAVY withMe can help your patients learn about access and cost support options that could assist them during their IMAAVY™ treatment journey
IMAAVY withMe Access Program
When commercial insurance coverage is delayed more than 5 business days or denied,
IMAAVY withMe offers eligible patients IMAAVY™ at no cost for up to 3 years or until their commercial insurance covers the medicine. See program requirements.
IMAAVY withMe Savings Program
Your eligible patients pay as little as $0 per infusion
IMAAVY withMe Savings Program
Your eligible patients pay as little as $0 per infusion
Program consists of Medicine Cost Support for the cost of IMAAVY™ medicine and Treatment Administration Cost Support for certain IMAAVY™ infusion administration and related monitoring costs. Maximum program benefit per calendar year shall apply. Offer subject to change or end without notice. Patients may participate without sharing their income information. See program requirements.
Affordability support for patients enrolled in government-funded healthcare programs
IMAAVY withMe can provide information about other resources that may be able to help your patients with their
out-of-pocket costs:
- State Pharmaceutical Assistance Programs (SPAPs)
- State Health Insurance Assistance Programs (SHIPs)
- Medicare Savings Program
- Independent foundations†
†Independent co-pay assistance foundations have their own rules for eligibility, which are subject to change. We have no control over these independent foundations and can only refer your patients to a foundation that supports their disease state. We do not endorse any particular foundation.
No insurance coverage
There may be resources to help with out-of-pocket treatment costs for patients without insurance. A Nurse Navigator* can help patients explore cost support options.
*Nurse Navigators do not provide medical advice. Patient Authorization is required for enrollment in Nurse Navigator support.
Call your Case Manager team at
844-4withMe (844-494-8463) or visit JNJwithMe.com/hcp/IMAAVY for more information on affordability programs that may be available.
Additional Affordability Support from
Johnson & Johnson
Patient assistance from Johnson & Johnson is available if your patient is uninsured or has commercial, employer-sponsored, or government coverage that does not fully meet their needs. Your patient may be eligible to receive their medicine from J&J at no cost for up to one year if they meet the eligibility and income requirements for the Johnson & Johnson Patient Assistance Program.
See terms and conditions at PatientAssistanceInfo.com/IMM or en español at
PatientAssistanceInfo.com/IMM/
844-4withMe(844-494-8463).
Affordability Support Resources
Download a digital brochure on cost support
options for your patient:
For more information on affordability programs that may be available, visit:
Help patients stay connected and on track with treatment
Enrolled patients have access to:
- Welcome materials to help patients get started on treatment and learn how to track how they’re doing with IMAAVY™
- Tailored resources to support each patient’s unique needs
- The Patient Portal, where they can:
- Update account and insurance information
- View IMAAVY withMe Savings Program status and details (if eligible)
- Receive content and messages about topics such as:
- Cost support options your patients may be eligible for
- Helpful treatment tips and IMAAVY™ information
- Advocacy programs
A Dedicated Nurse Navigator*
1-on-1 support from a registered nurse committed to helping patients and their caregivers
A dedicated IMAAVY withMe Nurse Navigator is a registered nurse who is available to provide your patients with disease education and treatment support.
Personalized support for your patients from a dedicated Nurse Navigator
- Helps patients with treatment onboarding and preparing for their infusions
- Directs patients to appropriate access and affordability resources
- Provides infusion support
- Gives ongoing support customized to each patient’s needs
- Sends infusion reminders
- Educates patients about their condition
- Nurse Navigators are available Monday–Friday, 8:00 AM–11:00 PM ET, with support available in up to 100 languages
*Nurse Navigators do not provide medical advice. Patient Authorization is required for enrollment in Nurse Navigator support.
Enroll your patients in this comprehensive program via the Provider Portal. To find an infusion center for IMAAVY™ treatment, use the Infusion Center Finder.
Need help? Call your Case Manager team at 844-4withMe (844-494-8463),
Monday–Friday, 8:00 AM–8:00 PM ET.
The patient support and resources provided by IMAAVY withMe are not intended to give medical advice, replace a treatment plan from the patient’s healthcare provider, offer services that would normally be performed by the provider’s office, or serve as a reason to prescribe IMAAVY™.
*Nurse Navigators do not provide medical advice. Patient Authorization is required for enrollment in Nurse Navigator support.
†The inclusion of an infusion center in the locator tool does not represent an endorsement from Johnson & Johnson. The locator tool is for informational purposes only. All users agree that use of the locator tool is at their own risk.
Patient support throughout the IMAAVY™ journey
Whether it’s help preparing for the first infusion or exploring cost support options that can assist with affordability, IMAAVY withMe provides support to patients and caregivers for managing their unique treatment journey.
Preparing for
Treatment
- Enrollment in IMAAVY withMe
- Select an infusion site
- Benefits Investigation (BI) and assessment of eligibility for patient support offerings
Access and Cost
Support
- IMAAVY withMe Access Program
- IMAAVY withMe Savings Program
- Cost support options for patients with government-funded coverage or no insurance coverage
First Infusion Support
- Nurse Navigator outreach
- Tailored resources
- Infusion Center Finder
Continuing Treatment
- Ongoing Nurse Navigator support
- Infusion reminders
- Connection to community resources
Preparing for Treatment
Once you have made the decision to prescribe IMAAVY™, here are the next steps:
Enrollment in IMAAVY withMe
- You can enroll patients through Portal.JNJwithMe.com
- Patients can self-enroll at IMAAVYwithMe.com/signup
Select an infusion site
Advise your patients about where they can receive their infusions:
- At your office (if equipped)
- At an infusion clinic. You can find infusion centers by using the
Infusion Center Finder† - At their home
Benefits investigation (BI) and patient support
- A streamlined BI will be performed
- The patient’s eligibility for support programs will be evaluated
†The inclusion of an infusion center in the locator tool does not represent an endorsement from Johnson & Johnson. The locator tool is for informational purposes only. All users agree that use of the locator tool is at their own risk.
IMAAVY withMe provides support to help your patients take charge of their journey.
If you have questions, call your Case Manager team at 844-4withMe (844-494-8463),
Monday-Friday, 8:00 AM-8:00 PM ET.
Resources
Schedule a meeting with a local Johnson & Johnson representative
Request a representativeOr call 844-4withMe (844-494-8463), Monday–Friday 8:00 AM–8:00 PM ET
for more information.
Frequently Asked Questions
IMAAVY withMe is a free support program that provides your patients who have been prescribed IMAAVY™ access to a Nurse Navigator,* tailored resources, and access and cost support options to help patients start and stay on track with treatment.
*Nurse Navigators do not provide medical advice. Patient Authorization is required for enrollment in Nurse Navigator support.
Patients 12 or older who have been prescribed IMAAVY™ for approved, on-label use are eligible for this program. For patients under 18 years of age, Nurse Navigator support is only available for the minor patient’s parent/legal guardian or legally authorized representative. For those eligible, IMAAVY withMe is completely free. Eligibility for program components may vary.
You can enroll your patients in IMAAVY withMe on the Provider Portal, or by calling 844-4withMe (844-494-8463), Monday–Friday, 8:00 AM–8:00 PM ET.
Your main points of contact at IMAAVY withMe will include:
- Your local Field Reimbursement Manager (FRM). By offering in-office educational support, an FRM can help your patients by:
- Working directly with your Case Manager team to help patients who have been prescribed IMAAVY™ get started on therapy as quickly as possible*
- Viewing patient-case details to help minimize delays*
- Delivering patient-case education to help patients start and stay on therapy*
- Contacting specialty pharmacies directly to inquire about specific patient cases*
- The Case Manager team. The Case Manager team provides customized support to help patients start and stay on therapy:
- Case Manager is the primary point of contact for patients, HCPs, and office staff
- Highly trained across all programs and skilled at matching patients to the right support
- Here to help with commercial prescription triage to mandated specialty pharmacies
*Protected Health Information cannot be exchanged without a Business Associate Agreement or Patient Authorization on file.
IMAAVY withMe supports your patients by helping you and your office staff:
- Understand your patients' insurance coverage for IMAAVY™
- Learn about cost support options for your patients
- Download up-to-date forms for prior authorization and get status of requests
- Understand the exceptions and appeals process
- Get coding and billing information for buy-and-bill
- Locate an infusion center, if needed
IMAAVY withMe supports your patients and their caregivers throughout the treatment journey with help that includes:
Information on the patient’s insurance coverage and cost
support—no matter what type of coverage the patient has- Nurse Navigator* outreach at key moments of the treatment journey
- Tailoring support resources for your patient’s unique needs
*Nurse Navigators do not provide medical advice. Patient Authorization is required for enrollment in Nurse Navigator support.
The patient support and resources provided by IMAAVY withMe are not intended to give medical advice, replace a treatment plan from the patient’s healthcare provider, offer services that would normally be performed by the provider’s office, or serve as a reason to prescribe IMAAVY™.