CommercialReimbursementMedium impact
Biosimilar Reimbursement Updates Effective January 1, 2026
CareFirst BlueCross BlueShield·Oncology, Rheumatology, Gastroenterology +3 more·Pharmacy
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield is updating reimbursement methodologies for biosimilar injectables and radiopharmaceuticals under their Medical Specialty Pharmacy (MSP) and Professional provider fee schedules effective January 1, 2026. This change will affect payment rates for select specialty pharmacy services to support more affordable care options.
Action Required
By December 31, 2025: Billing team must review CareFirst provider agreement to understand specific reimbursement rate changes for biosimilar injectables and radiopharmaceuticals. Access the full article at the source URL to identify affected drugs and updated payment amounts. Update billing system with new reimbursement rates for Medical Specialty Pharmacy services before January 1, 2026.