CommercialCoverageLow impact
Nuzyra (omadacycline)
Blue Cross & Blue Shield of Mississippi·MS · Infectious Disease, Emergency Medicine, Internal Medicine +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their policy on Nuzyra (omadacycline) antibiotic, maintaining their stance that it is not medically necessary due to insufficient evidence of greater clinical benefit compared to other available treatments for pneumonia and skin infections. The policy now references updated prescribing information from March 2025.
Action Required
Immediately: Billing team should note that HCPCS code J0121 (injection, omadacycline, 1 mg) remains listed as not medically necessary by BCBS Mississippi. Continue to expect denials for Nuzyra administration claims unless patient has State Health Plan coverage, which may have different formulary coverage through their pharmacy benefit manager.