Apellis Receives Permanent J-Code for SYFOVRE®

The U.S. Centers for Medicare & Medicaid Services (CMS) have officially designated a specific J-code (J2781) for Apellis Pharmaceuticals' Syfovre (pegcetacoplan injection), marking it as the first treatment for geographic atrophy (GA) secondary to age-related macular degeneration.

This J-code for Syfovre is scheduled to take effect on October 1, 2023.

J-codes serve as enduring reimbursement codes employed by government healthcare payers and private insurers, aiding in the billing procedures for Medicare Part B treatments, which necessitate administration by a healthcare professional. The utilization of J-codes serves to simplify and streamline billing and reimbursement procedures, facilitating efficient processing of claims.

"Until Syfovre, patients had nothing to slow the progression of this relentless and irreversible disease,” Adam Townsend, chief commercial officer, Apellis, said in a company news release. “The permanent J-code is a significant milestone that will help ensure accurate and efficient reimbursement of Syfovre in all treatment settings, building on our goal of bringing this important treatment to GA patients in need.”

The permanent J-code has been published by CMS here.