CommercialCoverageMedium impact
Extracorporeal Photopheresis
Blue Cross & Blue Shield of Mississippi·MS · Oncology, Hematology, Cardiology +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
This is a new Blue Cross Blue Shield Mississippi medical policy defining coverage criteria for Extracorporeal Photopheresis (ECP). The policy establishes when ECP is considered medically necessary versus investigational for cardiac transplant rejection, graft-versus-host disease, and cutaneous T-cell lymphoma treatment.
Action Required
Immediately: Billing team must review current ECP claims to ensure they meet the new medical necessity criteria. For cardiac allograft rejection, ECP is only covered when recurrent or refractory to standard treatment. For GVHD, ECP is only covered when refractory to medical therapy. For cutaneous T-cell lymphoma, ECP is covered for late-stage (III/IV) or early stage (I/II) that is progressive and refractory to nonsystemic therapies. Update prior authorization processes to verify these specific criteria are met before submitting claims.