CommercialCoverageMedium impact
Recarbrio (imipenem-cilastatin-relebactam)
Blue Cross & Blue Shield of Mississippi·MS · Infectious Disease, Critical Care, Emergency Medicine +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi has updated their policy stating that Recarbrio (imipenem-cilastatin-relebactam) is considered not medically necessary for all approved indications including hospital-acquired pneumonia, ventilator-associated pneumonia, complicated UTIs, and complicated intra-abdominal infections because other covered alternatives are available. The drug is also considered investigational for all other uses.
Action Required
Immediately: Billing team must flag HCPCS code J0742 (Recarbrio injection) as not covered by BCBS Mississippi due to availability of other covered alternatives. Update billing system to alert providers that claims for J0742 will likely be denied. Providers should use alternative covered antibiotics for hospital-acquired pneumonia, ventilator-associated pneumonia, complicated UTIs, and complicated intra-abdominal infections.