Products & Programs PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageMarch 19, 2025

Medicare Part B preapproval expands with new drug additions

Effective for dates of service on and after July 1, 2025, the specialty Medicare Part B drugs listed below will be included in our preapproval review process.

Federal and state law, as well as state contract language and CMS guidelines, including definitions and specific contract provisions/exclusions, take precedence over these preapproval rules and must be considered first when determining coverage. Please follow the new requirements to ensure your claims are accepted.

HCPCS or CPT® codes

Medicare Part B drugs

C9399, J9999

Aucatzyl (obecabtagene autoleucel)

Q5139

Bkemv (eculizumab-aeeb)

J3590

Epysqli (eculizumab-aagh)

C9399, J3590

Hympavzi (marstacimab-hncq)

J3590

Imuldosa (ustekinumab-srlf)

J3590

Otulfi (ustekinumab-aauz)

Q9997

Pyzchiva IV (ustekinumab-ttwe)

Q9998

Selarsdi (ustekinumab-aekn)

C9399, J9999

Tecentriq Hybreza (atezolizumab and hyaluronidase-tqjs)

C9399, J9999

Vyloy (zolbetuximab-clzb)

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