CommercialCoverageLow impact
State and School Employees' Health Insurance Plan - Zevaskyn (prademagene zamikeracel)
Blue Cross & Blue Shield of Mississippi·MS · Dermatology, Wound Care·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield of Mississippi has added a new policy declaring Zevaskyn (prademagene zamikeracel), a gene therapy for recessive dystrophic epidermolysis bullosa, as not medically necessary. A new HCPCS code J3389 was added effective January 1, 2026, but will be denied as not medically necessary.
Action Required
By January 1, 2026: Billing team must update denial expectations in billing system for HCPCS code J3389 (prademagene zamikeracel treatment). Configure system to flag this code as not covered by Mississippi State and School Employees' Health Plan. Inform providers that this gene therapy and its administration will be denied as not medically necessary.