CommercialPrior AuthMedium impact
Leukine (sargramostim)
Blue Cross & Blue Shield of Mississippi·MS · Oncology, Hematology·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS MS updated the Leukine (sargramostim) policy removing the prior authorization requirement and changing approval language from 'will be approved' to 'may be considered medically necessary.' The policy also clarified that drug samples cannot be used to satisfy medical policy requirements.
Action Required
Immediately: Update billing workflows to remove prior authorization requirements for Leukine (sargramostim) injection code J2820. Billing team should verify coverage through formulary drug search using patient's member ID before prescribing. Ensure documentation supports medical necessity criteria even though prior auth is no longer required.