Codes & NDC
| HCPCS | J9034 — "Inj., bendeka 1 mg" (permanent, Teva premixed) |
|---|
| NDC 100mg | 42367-521-25 (10) / 42367-0521-25 (11) — N4 + ML qualifier |
|---|
| NDC 200mg | 42367-531-26 (10) / 42367-0531-26 (11) — N4 + ML qualifier |
|---|
| Vials | 100 mg / 4 mL · 200 mg / 8 mL premixed (25 mg/mL); single-dose; no reconstitution |
|---|
| Class | Bendamustine HCl — alkylating agent + purine analog hybrid |
|---|
| Benefit | Medical (provider buy-and-bill); not specialty pharmacy |
|---|
Bendamustine formulation comparison
| HCPCS | Brand | Form | Infusion |
|---|
J9034 | Bendeka (Teva) | Premixed | 10 min |
J9033 | Treanda + generics | Lyophilized | 30–60 min |
J9036 | Belrapzo (Eagle) | Premixed | 10 min |
Generic J9033 ~50% cheaper. UHC/commercial may step-therapy through generic. Document why Bendeka (chair time, prior intolerance, contracting) in PA. NCCN treats all as equivalent.
Multi-indication dosing
| Indication | Dose | Schedule |
|---|
| CLL | 100 mg/m² | Days 1+2 / 28d × 6 cyc |
| iNHL post-rituximab | 120 mg/m² | Days 1+2 / 21d × 8 cyc |
| BR — 1L iNHL | 90 mg/m² | Days 1+2 / 28d × 6 cyc + R Day 1 |
| BR — MCL | 90 mg/m² | Days 1+2 / 28d ± R + other |
BR combo callout: Bendamustine + Rituximab is dominant 1L iNHL regimen and major MCL option. See /drugs/rituxan (J9312) for rituximab-side coding. On Day 1 BR cycle, sequence as 96413 (chemo initial) + 96417 (additional sequential infusion).
Premedication protocol
- Pre-infusion (every dose): antihistamine + antipyretic + corticosteroid
- TLS prophylaxis (cyc 1–2): allopurinol 300 mg PO daily for high tumor burden (CLL WBC > 50K)
- Infection prophylaxis: consider PCP (TMP/SMX); HBV screening before start
- Premeds bill separately (J1200 / J1100 / etc.) — NOT bundled into J9034
Administration & modifiers
| Code | When |
|---|
96413 | Chemo IV initial, 1 hr (primary) — 10-min infusion fits cleanly |
96417 | Sequential infusion — BR combo Day 1 for rituximab |
96365 | NOT appropriate — bendamustine is cytotoxic chemo |
JW > JZ for Bendeka. BSA dosing into fixed 100/200 mg vials = waste on most claims. Bill JW with discarded units on separate line. Missing JW = top audit flag.
ICD-10 — CLL
| Code | For |
|---|
C91.10 | CLL not in remission (most common 1L) |
C91.11 | CLL in remission |
C91.12 | CLL in relapse (most common 2L+) |
ICD-10 — iNHL & MCL
| Code | For |
|---|
C82.0–C82.9 | Follicular NHL (most common iNHL) |
C83.0x | Marginal zone / SLL |
C83.8x / C83.9x | Other / unspec B-cell NHL |
C83.1x | Mantle cell lymphoma (MCL) |
C88.0 | LPL / Waldenström (off-label, NCCN) |
iNHL 120 mg/m² indication = post-rituximab failure. PA must document prior rituximab regimen + progression within 6 months.
Payer requirements (May 2026)
| Payer | PA | Step / Preference |
|---|
| UnitedHealthcare | Yes | May prefer generic (J9033); pathology + Rx history req. |
| Aetna | Yes | Pathology; iNHL needs prior rituximab failure docs |
| Carelon / Anthem | Yes | NCCN-aligned + line-of-therapy docs |
| BCBS plans | Yes | Plan-specific; pathology + prior Rx |
Medicare reimbursement (Q2 2026)
| Field | Value |
|---|
| ASP + 6% (J9034) | $12.901 / mg (effective 4/1 – 6/30/2026) |
| 100 mg dose | $1,290.10 (100 units) |
| 170 mg dose (CLL @ 1.7 m²) | $2,193.17 |
| 200 mg dose | $2,580.20 |
| CLL annual (~12 inf, 1.7 m²) | ~$30,962 (incl. waste) |
| iNHL annual (~16 inf, 1.8 m²) | ~$61,925 (incl. waste) |
Site of care
| Setting | POS | Notes |
|---|
| Physician office | 11 | Preferred — 10-min fits |
| Ambulatory infusion suite | 49 | Preferred |
| Oncology ASC | 24 | Acceptable |
| Hospital outpatient | 22 / 19 | Disfavored after first cycle (commercial) |
Patient assistance — Teva Shared Solutions
- Phone: 1-888-825-1356 (Teva Shared Solutions)
- Co-pay program: commercially-insured (excludes Medicare/Medicaid)
- PAP: free product for uninsured/underinsured
- Foundations (Medicare): PAN, HealthWell, CancerCare, LLS Co-Pay Assistance
- Web: bendeka.com / tevasharedsolutions.com
W&P (no Boxed): myelosuppression (severe), opportunistic infections (PCP/CMV/HBV reactivation), tumor lysis syndrome, infusion reactions (~14%), severe skin reactions (SJS/TEN/DRESS — rare; risk increased with concurrent allopurinol), secondary malignancies (treatment-related AML/MDS).