CommercialPrior AuthLow impact
Crysvita (burosumab-twza)
Blue Cross & Blue Shield of Mississippi·MS · Nephrology, Endocrinology, Rheumatology +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their prior authorization policy for Crysvita (burosumab-twza), a specialized drug for treating X-linked hypophosphatemia and tumor-induced osteomalacia. The policy requires prior authorization with specific diagnostic criteria, lab values, and specialist involvement for both initial approval (6 months) and renewals (12 months).
Action Required
Immediately: For patients prescribed Crysvita (burosumab-twza), billing team must ensure prior authorization is obtained through BCBSMS PA process before administration. Verify specialist involvement (nephrologist, endocrinologist, rheumatologist, or oncologist) and required lab values (FGF23 levels, serum phosphorus) are documented. Claims for services related to delivery/administration will be denied without approved prior authorization.