CommercialCoverageMedium impact
Qutenza (capsaicin kit)
Blue Cross & Blue Shield of Mississippi·MS · Neurology, Pain Management, Endocrinology +3 more·Medical Policy
Effective date
Nov 1, 2025
We identified it
Jun 20, 2026
Summary
BCBS Mississippi has added a new policy effective November 1, 2025, declaring Qutenza (capsaicin 8% patch) not medically necessary for treating neuropathic pain associated with postherpetic neuralgia and diabetic peripheral neuropathy. Claims for this medication and its administration will be denied as other covered treatment options are available.
Action Required
Immediately: Billing team must update system to flag HCPCS code J7336 (capsaicin 8% patch) as not covered for BCBS Mississippi plans. Stop submitting claims for Qutenza and related administration services. Providers should be notified to use alternative covered treatments for neuropathic pain. Claims submitted will be denied as not medically necessary.