All PlansBilling CodesMedium impact
HCPCS replacement codes established, effective April 1, 2026
BCBS Michigan·MI · Oncology·Coding
Effective date
Apr 1, 2026
We identified it
Jun 16, 2026
Summary
CMS established new HCPCS codes for 8 specialty medical drugs effective April 1, 2026, replacing temporary codes. The billing team must update their systems to use the new permanent codes for all services performed on or after April 1, 2026, while continuing to use old codes for services through March 31, 2026.
Action Required
By April 1, 2026: Billing team must update billing system to use new codes: C9309 for Itvisma, J1553 for Yimmugo, J3404 for Papzimeos, J8502 for Aponvie, J9278 for Kyxata, J9601 for Lynozyfic, Q5161 for AUKELSO/BOSAYA, and Q5162 for BILDYOS/BILPREVDA. Remove old temporary codes from system for services on/after April 1. Verify prior authorization requirements are configured for applicable codes. Ensure staff know to use old codes for services through March 31, 2026.