MA08.108g, Polatuzumab vedotin-piiq (Polivy®)
Independence Blue Cross Medicare Advantage policy MA08.108g expands coverage for Polivy (HCPCS J9309): it adds the GemOx-R regimen for Burkitt lymphoma, refines CAR T-cell sequencing criteria, and adds ICD-10 codes as medically necessary. The policy became effective November 2, 2026, so it is already in effect, and it covers Polivy under the Part B medical benefit only, not the Part D pharmacy benefit.