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HCPCS replacement codes established, effective April 1, 2026
Act
by Apr 1, 2026
Effective date
Apr 1, 2026
Identified
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.
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What to do
by Apr 1, 2026 · 4 steps
01Billing 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.
02Remove old temporary codes from system for services on/after April 1.
03Verify prior authorization requirements are configured for applicable codes.
04Ensure staff know to use old codes for services through March 31, 2026.
Codes mentioned
C9309C9399J1553J3490J3590J9999J3404J8502C9145J9278C9308J9601C9307Q5161Q5162
Original notice
HCPCS replacement codes established, effective April 1, 2026
bcbsm.com · Always check the source before changing claims.
Related changes
See all BCBS Michigan changes →HCPCS 1st-quarter update: New, deleted codesHighEffective Apr 1, 2026 · CodingHCPCS replacement codes established, effective July 1, 2026HighEffective Jul 1, 2026 · CodingAdditional drugs to require prior authorization for Medicare Advantage members, starting May 11MediumEffective May 11, 2026 · Prior AuthorizationWe’re adding requirements for additional medical oncology drugs for most members, starting May 13HighEffective May 13, 2026 · Specialty ServicesBrowse every BCBS Michigan change in the policy list