Topic

Kuvan (sapropterin dihydrochloride)

A collection of 34 issues

Renewing Kuvan (Sapropterin) Approval with UnitedHealthcare in Washington: 2025 Requirements & Timeline

Answer Box: Kuvan Renewal Requirements UnitedHealthcare requires annual prior authorization renewal for Kuvan (sapropterin) with specific documentation: active phenylalanine-restricted diet, sustained blood Phe reduction from baseline (typically ≥20-30%), and confirmation you're not using concurrent Palynziq therapy. Start renewal 60-90 days before expiration. Submit through the UnitedHealthcare Provider Portal
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How to Get Kuvan (Sapropterin) Covered by UnitedHealthcare in Pennsylvania: Complete Forms, Appeals & Timeline Guide

Answer Box: Getting Kuvan Covered by UnitedHealthcare in Pennsylvania UnitedHealthcare requires prior authorization for Kuvan (sapropterin) in Pennsylvania through OptumRx. You'll need PKU diagnosis documentation, phenylalanine levels, and proof of dietary management. Submit via the UnitedHealthcare Provider Portal with complete clinical records. If denied, Pennsylvania's new
6 min read

UnitedHealthcare's Coverage Criteria for Kuvan (Sapropterin) in California: Complete Prior Authorization Guide 2025

Answer Box: Getting Kuvan Covered by UnitedHealthcare in California UnitedHealthcare requires prior authorization for Kuvan (sapropterin dihydrochloride) with specific criteria: confirmed PKU diagnosis, active phenylalanine-restricted diet, and no concurrent Palynziq use. Submit through the UnitedHealthcare Provider Portal or call 866-889-8054. If denied, California residents can file a free Independent Medical
5 min read

Myths vs. Facts: Getting Kuvan (Sapropterin) Covered by Humana in Florida – Complete Coverage Guide

Answer Box: Getting Kuvan Covered by Humana in Florida Eligibility: Humana Medicare plans in Florida require prior authorization for Kuvan (sapropterin) with documented PKU diagnosis, specialist oversight, and proof of BH4 responsiveness (≥30% phenylalanine reduction). Fastest path: Submit complete PA documentation including baseline/follow-up Phe levels, specialist letter, and dietary
6 min read

How Long Does It Take to Get Kuvan Approved by Humana in Washington? Complete Timeline & Requirements

Answer Box: Getting Kuvan Approved by Humana in Washington Standard timeline: 7 days for complete prior authorization submissions. Humana requires prior authorization for all Kuvan (sapropterin) prescriptions under Medicare Advantage and Part D plans. Fastest path: Submit electronically via CoverMyMeds with complete PKU documentation including BH4 responsiveness trial results, specialist
5 min read

Complete Coding Guide: Getting Kuvan (Sapropterin) Covered by Humana in Pennsylvania - ICD-10, NDC, and Prior Authorization Requirements

Answer Box: Fastest Path to Kuvan Coverage with Humana in Pennsylvania Kuvan (sapropterin dihydrochloride) requires prior authorization from Humana Medicare Advantage plans in Pennsylvania. Submit requests using the correct NDC code (not J-codes), ICD-10 code E70.0 (classical PKU) or E70.1 (other hyperphenylalaninemias), and comprehensive documentation showing BH4 responsiveness.
6 min read