CommercialCoverageMedium impact
Fecal Microbiota Transplantation 2.01.48
Excellus BlueCross BlueShield·Gastroenterology·Digestive System (Gastroenterology)
Effective date
Sep 18, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield updated their Fecal Microbiota Transplantation policy, establishing coverage criteria for recurrent C. difficile infections (requiring 3+ episodes total and proper donor screening) while considering all other uses investigational. This policy specifically affects gastroenterology practices treating C. diff patients.
Action Required
By September 18, 2025: Gastroenterology providers must ensure FMT cases meet strict criteria - patient must have 2+ recurrences after initial C. diff episode (3+ total episodes) and appropriate donor stool screening must be completed. Update clinical protocols to document these requirements as FMT for other indications will be considered investigational and likely not covered.