California
Provider Communications
Specialty pharmacy precertification list expansion
Effective for dates of service on and after April 1, 2023, the specialty Medicare Part B drugs listed in the table below will be included in our precertification review process.
Featured In:
February 2023 Anthem Blue Cross Provider News - California
Federal and state law, as well as state contract language and CMS guidelines, including definitions and specific contract provisions/exclusions, take precedence over these precertification rules and must be considered first when determining coverage. Noncompliance with new requirements may result in denied claims.
|
HCPCS or CPT® codes |
Medicare Part B drugs |
|
C9399, J3490, J3590 |
Rolvedon (eflapegrastim-xnst) |
|
C9399, J3490, J3590 |
Stimufend (pegfilgrastim-fpgk) |
Featured In:
February 2023 Anthem Blue Cross Provider News - California