CommercialPrior AuthMedium impact
Fetroja (cefiderocol sulfate tosylate)
Blue Cross & Blue Shield of Mississippi·MS · Infectious Disease, Critical Care, Urology +1 more·Medical Policy
Effective date
Dec 2, 2025
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their policy for Fetroja (cefiderocol sulfate tosylate) effective December 2, 2025, adding explicit prior authorization requirements and clarifying that drug samples cannot be used to satisfy medical policy requirements. The policy covers specific gram-negative bacterial infections with strict criteria including culture/sensitivity testing and limited treatment alternatives.
Action Required
Immediately: Billing team must ensure prior authorization is obtained before administering Fetroja (HCPCS J0699) for BCBS Mississippi patients. Update billing system to flag this code for prior auth requirement. Providers must document culture/sensitivity results, limited treatment alternatives, and ensure patients are >18 years old with qualifying infections. Claims will be denied without proper authorization.