Effective July 1, CMS and commercial health insurers will recognize the assigned A9596 Healthcare Common Procedure Coding System (HCPCS) Level II code for reimbursement of Illuccix. The transitional pass-through payment status, which also takes effect on July 1, will enable CMS to provide separate payments for the radiopharmaceutical and the PET/CT scan when performed with Illuccix in the hospital outpatient setting, according to Telix.

Cleared in December 2021, Illuccix is a kit for preparing gallium-68 gozetotide injections for PET imaging in men with suspected prostate cancer metastasis who are candidates for initial definitive therapy or whose cancer may have recurred based on elevated serum prostate-specific antigen levels.