Does California Physicians' Service require prior authorization for Matulane?
California Physicians' Service does not require prior authorization for Matulane on the Medicare Part D plans that cover it.
No covering plan from this payer files a prior-authorization requirement for this drug.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| procarbazine 50 MG Oral Capsule [Matulane]207588 | 17 / 17 | 0 | 0 | 0 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — procarbazine 50 MG Oral Capsule [Matulane]
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Blue Shield 65 Plus (HMO) | H0504-015 | 5 | No | No | No |
| Blue Shield 65 Plus (HMO) | H0504-017 | 5 | No | No | No |
| Blue Shield 65 Plus (HMO) | H0504-026 | 5 | No | No | No |
| Blue Shield 65 Plus (HMO) | H0504-028 | 5 | No | No | No |
| Blue Shield 65 Plus (HMO) | H0504-038 | 5 | No | No | No |
| Blue Shield 65 Plus (HMO) | H0504-039 | 5 | No | No | No |
| Blue Shield 65 Plus Choice Plan (HMO) | H0504-040 | 5 | No | No | No |
| Blue Shield 65 Plus Plan 2 (HMO) | H0504-021 | 5 | No | No | No |
| Blue Shield Advantage (HMO) | H0504-050 | 5 | No | No | No |
| Blue Shield AdvantageOptimum Plan (HMO) | H5928-004 | 5 | No | No | No |
| Blue Shield AdvantageOptimum Plan 1 (HMO) | H5928-010 | 5 | No | No | No |
| Blue Shield Inspire (HMO) | H0504-041 | 5 | No | No | No |
| Blue Shield Inspire (HMO) | H0504-043 | 5 | No | No | No |
| Blue Shield Inspire (HMO) | H0504-047 | 5 | No | No | No |
| Blue Shield Rx Enhanced (PDP) | S2468-004 | 5 | No | No | No |
| Blue Shield Rx Plus (PDP) | S2468-003 | 5 | No | No | No |
| Blue Shield TotalDual Plan (HMO D-SNP) | H2819-001 | 5 | No | No | No |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
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Matulane at other payers
Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.