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01/21/2026

Aetna

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Changes to our National Precertification List (NPL)
These changes apply to our commercial and Medicare members, unless otherwise noted.

Effective January 1, 2026, we’ll require precertification for the following:

  • Electrophysiological (EP) study (93654)
  • Yondelis (trabectedin, J9352)
  • Docivyx (docetaxel, J9172) - Medicare members only

Changes to Commercial Drug Lists Begin on January 1, 2026
Find out about drug list changes and how to request drug prior authorizations (PAs).

On January 1, 2026, we’ll update our pharmacy drug lists. Changes may affect all drug lists, precertification, step therapy, and quantity limit programs. You’ll be able to view the changes here Formularies and Pharmacy Clinical Policy Bulletins

Ways to request a drug PA

  • Submit your PA through CoverMyMeds.
  • For requests for non-specialty drugs, call 1-800-294-5979 (TTY: 711). Or fax your authorization request form to 1-888-836-0730.
  • For requests for drugs on the Aetna Specialty Drug List, call 1-866-814-5506 (TTY:711) or go to our Forms for Health Care Professionals page and scroll down to the Specialty Pharmacy Precertification (commercial) drop-down menu. If the specific form you need is not there, scroll to the end of the list and use the generic Specialty Medication Precertification Request Form. Once you fill out the relevant form, fax it to 1-866-249-6155.

Medications on the Aetna Drug Guide, precertification, step-therapy, and quantity limits lists are subject to change.

More information
For more information, refer to the Contact Aetna page and select the Providers tab.

 

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