CommercialPrior AuthLow impact
Nuedexta (dextromethorphan and quinidine)
Blue Cross & Blue Shield of Mississippi·MS · Neurology, Family Medicine, Internal Medicine·Medical Policy
Effective date
Dec 2, 2025
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their prior authorization policy for Nuedexta (dextromethorphan and quinidine) used to treat pseudobulbar affect. Key changes include clarifying that drug samples cannot be used to satisfy medical policy requirements and updating terminology from 'Member' to 'individual' throughout the policy.
Action Required
Immediately: Billing team must ensure prior authorization is obtained for all Nuedexta prescriptions before submission. Do not accept drug samples as evidence of current therapy when submitting prior authorization requests. Update any internal documentation templates to reflect that samples cannot satisfy medical necessity requirements.