We’re Here to Support Your Eligible Patients During Treatment
Our mission is to help your patients start and stay on therapy by assisting with access and as-needed support.
When You Enroll a Patient, an IncyteCARES for MONJUVI Representative Will:
- Call your patient to welcome them and explain their insurance coverage for MONJUVI® (tafasitamab-cxix)
- Assess your patient’s eligibility for savings or financial assistance programs,* and help them enroll
- Explain the additional support and resources available to them during treatment
*Terms and conditions apply. Program terms may change at any time.
Enroll Your Eligible Patients in IncyteCARES for MONJUVI
Completing the IncyteCARES for MONJUVI enrollment form takes about
15 minutes. Simply download, complete, and fax it.
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Savings, Financial Assistance, and Support Options for MONJUVI
For Eligible Patients With Commercial Health Insurance
IncyteCARES for MONJUVI Savings Program
IncyteCARES for MONJUVI Savings Program
Eligible patients can receive MONJUVI for as little as $0, subject to certain limits†
To qualify, patients must:
- Have commercial healthcare coverage. Patients insured under federal or state government healthcare programs— including Medicare Part B, Medicare Advantage, Medicaid, TRICARE, or any state medical or pharmaceutical assistance program—are not eligible. Patients without healthcare coverage are also not eligible
- Be a resident of the United States or Puerto Rico
- Have a valid prescription for MONJUVI for an FDA-approved use
†Uninsured, cash-paying, or Alternate Funding Program (AFP) patients are not eligible. Not valid for patients insured through Medicare Part B, Medicare Advantage, Medicaid, TRICARE, or any state medical or pharmaceutical assistance program. Patient enrollment in a copay adjustment program, such as a maximizer or accumulator program, may impact the value of this offer. Annual benefit maximum applies, as may other restrictions. Program benefit applies to medication cost only and does not cover any costs to administer the medication. Valid prescription for MONJUVI® (tafasitamab-cxix) for an FDA-approved indication or compendia-recognized use is required. Please see the full Patient Terms and Conditions or call IncyteCARES for MONJUVI at 1-855-452-5234. Update effective as of May 1, 2024.
†Uninsured, cash-paying, or Alternate Funding Program (AFP) patients are not eligible. Not valid for patients insured through Medicare Part B, Medicare Advantage, Medicaid, TRICARE, or any state medical or pharmaceutical assistance program. Patient enrollment in a copay adjustment program, such as a maximizer or accumulator program, may impact the value of this offer. Annual benefit maximum applies, as may other restrictions. Program benefit applies to medication cost only and does not cover any costs to administer the medication. Valid prescription for MONJUVI® (tafasitamab-cxix) for an FDA-approved indication or compendia-recognized use is required. Please see the full Patient Terms and Conditions or call IncyteCARES for MONJUVI at 1-855-452-5234. Update effective as of May 1, 2024.
Enroll your patient in IncyteCARES for MONJUVI
We’ll do the rest. As part of our introductory call, we inform all newly enrolled patients about the IncyteCARES for MONJUVI Savings Program and help eligible patients to apply for it. Simply complete and fax the program enrollment form to 1-866-870-6241.
For questions about the Savings Program, call IncyteCARES for MONJUVI at 1-855-452-5234, Monday through
How to request payment of your Savings Program patient’s coinsurance responsibility
Once your patient has been treated with MONJUVI, you can submit the documentation for your patient’s coinsurance responsibility by fax. We will match their Savings Program Member ID to the documentation for processing, then issue you a check referencing your patient’s name.
Be sure to submit the following proofs of purchase:
- CMS-1500 claim form
- or
- Explanation of Benefits (EOB) from the primary commercial payer showing patient name and date of birth, medication name or NDC, patient responsibility amount, and date of service
Fax payment requests and documentation to 1-866-870-6241.
For questions about this process, call 1-855-452-5234.
For Eligible Patients Who Are Uninsured or Underinsured for MONJUVI
IncyteCARES for MONJUVI Patient Assistance Program
IncyteCARES for MONJUVI Patient Assistance Program
Eligible patients can receive medication free of charge‡
The IncyteCARES for MONJUVI Patient Assistance Program (PAP) helps eligible patients who do not have medical insurance or who have trouble affording their out-of-pocket costs for MONJUVI. The program provides free medication, but does not cover the cost to administer infusions. No purchase contingencies or other obligations apply.
To qualify, patients must:
- Be confirmed as eligible for and enrolled in IncyteCARES for MONJUVI
- Be a resident of the United States or Puerto Rico
- Have a valid prescription for MONJUVI for an FDA-approved use
- Meet one of these 3 criteria:
Uninsured
- Have no medical coverage and meet household income criteria
Underinsured§
- text
- Have Medicare Part B and meet household income criteria
- Have any other type of healthcare insurance (commercial, Medicaid, etc) but have exhausted or been denied coverage for MONJUVI and meet household income criteria
How to enroll your patients:
First, you must enroll your patient in IncyteCARES for MONJUVI.
If you’re not able to provide the patient’s required income information and/or authorizations on the form, a program representative will contact the patient by phone to gather this information.
For questions, call IncyteCARES for MONJUVI at 1-855-452-5234, Monday through Friday,
‡Terms and conditions apply. Terms of this program may change at any time.
§Patients who are enrolled in an Alternate Funding Program (AFP) are not eligible to receive free drug.
For All Patients
Information About Nonprofit or Other Support Organizations
Information About Nonprofit or Other Support Organizations
Patients may be eligible for help with medicine, treatment-related travel, and other costs.
If patients do not qualify for our IncyteCARES Savings or Patient Assistance Programs, we may be able to provide information about other organizations or independent foundations that offer support. If eligible, these independent organizations sometimes provide help with medicine costs, transportation or lodging expenses related to treatment, or counseling services offered at reduced or no cost. Eligibility and availability of these programs are determined by the individual organizations.
To learn more:
Call IncyteCARES for MONJUVI at 1-855-452-5234, Monday through Friday,
We can give patients contact information and website addresses to find more information on other organizations and independent foundations that may be able to help with specific needs.
Practice Resources: ICD-10-CM Codes
The following codes are from the International Classification of Diseases, Clinical Modification
Body Area Affected by Diffuse Large
ICD-10-CM Code
Unspecified site
C83.30
Lymph nodes of head, face, and neck
C83.31
Intrathoracic lymph nodes
C83.32
Intra-abdominal lymph nodes
C83.33
Lymph nodes of axilla and upper limb
C83.34
Lymph nodes of inguinal region and lower limb
C83.35
Intrapelvic lymph nodes
C83.36
Spleen
C83.37
Lymph nodes of multiple sites
C83.38
Extranodal and solid organ sites
C83.39
Incyte has provided these codes as background information. They are some of the available ICD-10-CM codes that relate to this disease state. They are not intended to encourage or address the use of any specific ICD-10-CM codes for individual patients. Using the codes provided does not guarantee or support payment, coverage, or reimbursement decisions.
For more information about ICD-10-CM codes, visit CMS.gov.
