Ocrevus Prior Authorization Resources

Find the right PA form for your patient's payer, get the ICD-10 codes you need, and download appeal templates — all in one place.

Last verified: May 11, 2026

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield · Updated May 11, 2026
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc. · Updated May 11, 2026
California - Uniform Prior Authorization FormCalifornia · Updated Apr 16, 2026
CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc. · Updated May 11, 2026
Cigna - General Medication Prior Authorization FormCigna Corporation · Updated May 11, 2026
Cigna - Ocrevus Prior Authorization Form Cigna Corporation · Updated Apr 16, 2026

ICD-10 codes for Ocrevus Prior Authorizations

G35Multiple sclerosis

Appeal Templates

If the payer denies coverage, these templates help you build a stronger appeal.
Coverage Authorization Appeals - Patients New to Ocrevus Coverage Authorization Appeals - Patients New to Ocrevus resource
Coverage Authorization Appeals - Patients Converting to OcrevusCoverage Authorization Appeals - Patients Converting to Ocrevus resource
Coverage Authorization Appeals - Patients to Remain on OcrevusCoverage Authorization Appeals - Patients to Remain on Ocrevus resource
Letter of Medical Necessity - Patients New to OcrevusLetter of Medical Necessity - Patients New to Ocrevus resource
Letter of Medical Necessity - Patients Converting to OcrevusLetter of Medical Necessity - Patients Converting to Ocrevus resource
Letter of Medical Necessity - Patients to Remain on OcrevusLetter of Medical Necessity - Patients to Remain on Ocrevus resource
A peer-to-peer review with the payer's medical director can often resolve denials faster than a formal appeal.

Brand Resources

Reimbursement Information Reimbursement Information resource
Pharmacy List Pharmacy List resource
How To Order Ocrevus How To Order Ocrevus resource
Billing & Coding Guide Billing & Coding Guide resource

Support for Getting Your Patient on Ocrevus