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Targeted Phototherapy and Psoralen with Ultraviolet A for Vitiligo
Blue Cross & Blue Shield of Mississippi·MS · Dermatology·Medical Policy
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield MS policy L.2.01.443 clarifies coverage for vitiligo treatments: PUVA therapy is considered medically necessary for vitiligo not responsive to conservative therapy, while targeted phototherapy remains investigational and not covered. The policy number changed from A.2.01.86 to L.2.01.443 but coverage statements remain unchanged.
Action Required
Update billing system and staff training materials to reflect new policy number L.2.01.443 (formerly A.2.01.86). Ensure PUVA therapy claims for vitiligo include documentation showing failure of conservative treatments like topical corticosteroids, coal/tar preparations, and UV light. Do not submit claims for targeted phototherapy for vitiligo as it is considered investigational and will be denied.