Medicaid
Covered with requirementsWhat you need to qualify
- Diagnosis documented with a code (K76.0, K75.8)
- Confirmed MASH diagnosis
Qualification pathways
You can qualify through any one of these.
MASH without cirrhosis — no PA required with correct diagnosis code
All of:
- Noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) diagnosis
- Claim submitted with ICD-10-CM diagnosis code K76.0 and/or K75.8
Documentation to bring
- ICD-10-CM diagnosis code K76.0 (Fatty (change of) liver, not elsewhere classified) and/or K75.8 (Other specified inflammatory liver diseases) submitted on claim
Not covered when
- Cirrhotic MASH not addressed; document specifies noncirrhotic MASH only
Policy note: Effective April 1, 2026. No PA required when claim is submitted with the appropriate ICD-10-CM diagnosis code (K76.0 and/or K75.8). Claims without the appropriate code will deny with Reject Code 80. Document does not specify detailed clinical criteria (fibrosis stage, confirmation methods, etc.) beyond the diagnosis code requirement.
Policy effective April 6, 2026 · verified June 3, 2026 · source: 12_A_GLP-1_Coverage_Considerations.pdf