BCBSGa expands specialty pharmacy level of care (clinical site of care) drug list

Effective for dates of service on and after January 1, 2019, the following specialty pharmacy codes from new or current medical policies or clinical UM guidelines will be included in our existing specialty pharmacy level of care review process.

 

BCBSGa’s level of care prior authorization clinical review of these specialty pharmacy drugs will be managed by AIM Specialty Health® (AIM), a separate company.

 

View the Level of Care (Clinical Site of Care) drug list and Level of Care (Clinical Site of Care) pre-service clinical review FAQs for more information.

Medical Policy or Clinical UM Guideline	Drug	HCPCS or CPT Code	NDC Code
CG-DRUG-16	Fulphila™	Q5108	67457-0833-06