CommercialJune 1, 2025
Policy updates — designated medical specialty pharmacy
On August 1, 2025, the following updates to the Designated Medical Specialty Pharmacy Drug List will go into effect.
- Soliris (eculizumab) will use a new HCPCS code — J1299.
- The drug(s) below will be removed from the list:
HCPCS | Description | Brand name |
J9039 | INJECTION BLINATUMOMAB 1 MICROGRAM | BLINCYTO |
To review the current Designated Medical Specialty Pharmacy Drug List, go to https://anthem.com/provider and select Missouri > Resources > Forms and Guides > Pharmacy.
If you have questions or want to discuss the terms and conditions for providing certain specialty medications, please contact your provider relationship management representative.
In Missouri (excluding 30 counties in the Kansas City area): Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
MOBCBS-CM-081336-25
PUBLICATIONS: June 2025 Provider Newsletter
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