CommercialCoverageMedium impact
Treatment of Epidermolysis Bullosa
Blue Cross & Blue Shield of Mississippi·MS · Dermatology, Wound Care·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
BCBS Mississippi added a policy exception excluding gene therapy coverage for State Health Plan participants effective January 1, 2025. This specifically affects Vyjuvek (beremagene geperpavec-svdt) gene therapy for epidermolysis bullosa treatment, while Filsuvez remains non-covered with formulary alternatives available.
Action Required
Immediately: Billing team must update system to deny all gene therapy claims for State Health Plan (State and School Employees) participants effective January 1, 2025. Flag Vyjuvek (J3401) and related gene therapy codes as non-covered for these specific plan members. Verify patient eligibility and plan type before scheduling gene therapy treatments to avoid claim denials.