Ordering and Reimbursement Resources for PYLARIFY®
PYLARIFY® Availability
PYLARIFY® is Available Nationwide
For information about ordering PYLARIFY® for your imaging site, and how to get started, contact PYLARIFY®
Customer Support at 1-800-964-0446 1-800-964-0446 M-F 8:30 am-8:00 pm ET, or email cspyl@lantheus.com.
Please refer to the map below for the production site nearest you.
Delivery time and delivery area may vary. For more information about ordering
PYLARIFY® outside available cities, please call 1-800-964-04461-800-964-0446.
Available Now
- Alabama, Birmingham
- Arizona, Phoenix
- Arkansas, Little Rock
- California, Culver City
- California, Gilroy
- California, Loma Linda
- California, Sacramento
- California, San Francisco
- Colorado, Denver
- Florida, Fort Lauderdale
- Florida, Jacksonville
- Florida, Sanford
- Florida, Tampa
- Georgia, Atlanta
- Illinois, Chicago
- Illinois, Romeoville
- Iowa, Davenport
- Kansas, Kansas City
- Kentucky, Louisville
- Louisiana, Covington
- Massachusetts, Boston
- Massachusetts, Haverhill
- Michigan, Detroit
- Minnesota, Minneapolis
- Missouri, Columbia
- Missouri, Kansas City
- Nevada, Las Vegas
- New Jersey, Hackensack
- New Jersey, Somerset
- New Jersey, Totowa
- New Mexico, Albuquerque
- New York, Albany *
- New York, Bronx
- North Carolina, Raleigh
- North Carolina, Winston-Salem
- Ohio, Cincinnati
- Ohio, Cleveland
- Ohio, Oakwood Village
- Oklahoma, Tulsa
- Oregon, Portland
- Pennsylvania, Philadelphia
- Puerto Rico, San Juan
- South Carolina, Columbia
- Tennessee, Gray
- Tennessee, Knoxville
- Tennessee, Nashville
- Texas, Dallas *
- Texas, Houston *
- Utah, Salt Lake City
- Virginia, Sterling
- Washington, Seattle
- Washington, Spokane
- West Virginia, Morgantown
- Wisconsin, Milwaukee
- Kentucky, Louisville
- Louisiana, Covington
- Massachusetts, Boston
- Massachusetts, Haverhill
- Michigan, Detroit
- Minnesota, Minneapolis
- Missouri, Columbia
- Missouri, Kansas City
- Nevada, Las Vegas
- New Jersey, Hackensack
- New Jersey, Somerset
- New Jersey, Totowa
- New Mexico, Albuquerque
- New York, Albany *
- New York, Bronx
- North Carolina, Raleigh
- North Carolina, Winston-Salem
- Ohio, Cincinnati
- Ohio, Cleveland
- Ohio, Oakwood Village
- Oklahoma, Tulsa
- Oregon, Portland
- Pennsylvania, Philadelphia
- Puerto Rico, San Juan
- South Carolina, Columbia
- Tennessee, Gray
- Tennessee, Knoxville
- Tennessee, Nashville
- Texas, Dallas *
- Texas, Houston *
- Utah, Salt Lake City
- Virginia, Sterling
- Washington, Seattle
- Washington, Spokane
- West Virginia, Morgantown
- Wisconsin, Milwaukee
Planned Future Sites
- Missouri, St. Louis
- *2 manufacturing sites
Delivery time and delivery area may vary. For more information about ordering
PYLARIFY® outside available cities, please call 1-800-964-04461-800-964-0446.
Reimbursement Resources
>90% of covered lives have access to PYLARIFY®. To better serve patients with prostate cancer, Lantheus created our Market Access Leader team and a dedicated Support Hotline that offers a suite of services designed to assist providers and patients with Lantheus products. Our team of reimbursement and payer specialists provide answers regarding insurance coverage, billing, coding, prior authorization questions and ongoing patient support. For questions relating to reimbursement for patients, providers, and payers, please call the Reimbursement Hotline or download the resources below.
Reimbursement Hotline:
844-339-8514844-339-8514
- Billing, Coding, and Claims Information for PYLARIFY® (piflufolastat F 18) injection and related procedures
- Coverage for Specific Payers: We can assist with claims and coverage issues for PYLARIFY® and related procedures with your local and regional payers
- Radiology Benefit Managers (RBMs): While payers pay your claims, many have handed coverage off to their RBM partners. These partners develop clinical coverage guidelines that will determine what procedures will be approved—we can provide support to establish coverage and assist in pre-authorization of claims with the RBMs you deal with
- Benefit Investigation: The Hotline will verify patient insurance benefits, including deductible and copayments, any prior authorization requirements, and determine any possible coverage restrictions such as to network or place of service
- Prior Authorization (PA) Assistance: If PA is required, we will work with providers on submitting a request for prior authorization and assist in appealing a denied request for approval
- Appeal/Peer-to-Peer Assistance: When a claim is denied, we offer assistance on appealing the denial with the payer
- PYLARIFY® Coding and Billing Guide: Includes PYLARIFY® billing codes (NDC, Diagnosis/ICD 10 code[s], CPT, HCPCS [J-code, A-code]), as well as details about PYLARIFY® access and reimbursement support services
- PYLARIFY® Access & Reimbursement Best Practices Guide: Includes recommendations for inquiring with a patient’s payer prior to administration, managing expectations for cost and coverage, steps to take upon potential denials, and reimbursement scenarios/cases
- Patient Brochure: Includes information on prostate cancer, an overview on how PYLARIFY® can help create an optimal treatment plan as well as what to expect when having a PET scan
INDICATION & IMPORTANT
SAFETY INFORMATION
PYLARIFY® (piflufolastat F 18) Injection is a radioactive diagnostic agent indicated for positron emission tomography (PET) of prostate-specific membrane antigen (PSMA) positive lesions in men with prostate cancer:
- with suspected metastasis who are candidates for initial definitive therapy.
- with suspected recurrence based on elevated serum prostate-specific antigen (PSA) level.
References
- FDA clearance letter for aPROMISE X. Food and Drug Administration. April 29, 2022.
