CommercialPrior AuthLow impact
Revcovi (elapegademase-lvlr)
Blue Cross & Blue Shield of Mississippi·MS · Hematology, Allergy & Immunology, Oncology +1 more·Medical Policy
Effective date
Sep 1, 2025
We identified it
Jun 20, 2026
Summary
BCBS MS has added a new medical policy for Revcovi (elapegademase-lvlr), a specialty drug for ADA-SCID treatment, requiring prior authorization with strict criteria including genetic testing confirmation and specialist prescribing requirements. This is a completely new policy effective September 1, 2025.
Action Required
By September 1, 2025: Billing team must update prior authorization requirements for Revcovi (elapegademase-lvlr) billed under HCPCS J3590. Ensure providers obtain prior auth before prescribing, confirm diagnosis with genetic testing results, verify specialist prescriber (immunologist/hematologist/oncologist), and document absence of contraindications. Claims without prior authorization will be denied.