CommercialCoverageMedium impact
Agents for Recurrent Clostridioides Difficile
Blue Cross & Blue Shield of Mississippi·MS · Gastroenterology, Infectious Disease, Internal Medicine +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi has updated their policy to classify Rebyota and Vowst (fecal microbiota treatments) as not medically necessary for preventing recurrent C. difficile infections, citing other covered treatment options. Administration and delivery services for these medications are also considered not medically necessary.
Action Required
Immediately: Billing team must flag codes C9399, J1440, and J3590 as non-covered for BCBS Mississippi when related to Rebyota or Vowst treatments for C. difficile prevention. Update billing system to alert staff that these fecal microbiota treatments and their administration services will be denied. Verify formulary coverage for each patient's specific benefit plan before prescribing.