CommercialCoverageMedium impact
State and School Employees' Health Insurance Plan - Xiaflex (collagenase clostridium histolyticum)
Blue Cross & Blue Shield of Mississippi·MS · Urology, Orthopedics, Plastic Surgery·Medical Policy
Effective date
Sep 1, 2025
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their Xiaflex (collagenase clostridium histolyticum) policy on 09/01/2025, adding stricter criteria for Dupuytren's contracture requiring at least 20-degree contracture and no surgical treatment within 90 days. The policy also clarified that drug samples cannot be used to satisfy medical necessity requirements.
Action Required
Immediately: Update prior authorization documentation for Xiaflex injections to include measurement of contracture degrees (minimum 20 degrees for Dupuytren's contracture, 30 degrees for Peyronie's disease) and confirm no surgical treatment within 90 days for Dupuytren's cases. Verify prescribing providers are certified through Xiaflex REMS Program for Peyronie's disease treatment. Do not use drug samples as justification for medical necessity in prior authorization requests.