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Medical Policy and Coding Updates - March 2025
Effective date
Not stated in the notice
Identified
Jun 16, 2026
Summary
Premera's March 2025 update changes adalimumab and pegfilgrastim preferences, with Humira (AbbVie) moving from a preferred to a non-preferred adalimumab product effective July 1, 2025. It also adds new Parkinson's disease and seizure drug policies effective March 1, 2025, and lists code 92972 as now requiring review for investigational, while several SARS-CoV-2 serology codes and code 25448 no longer require review.
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What to do
Action · 5 steps
01Already effective July 1, 2025, June 6, 2025, May 6, 2025, April 20, 2025, April 6, 2025, March 5, 2025 and March 1, 2025, so check current applicability before acting on these past dates.
02Billing team: Humira (AbbVie) (adalimumab) [NDCs starting with 00074] changed from a preferred to a non-preferred adalimumab product, effective July 1, 2025.
03Billing team: Udenyca (pegfilgrastim-cbqv) and Udenyca Onbody moved from second-line to first-line therapy for individuals younger than 18 years of age, and from third-line to second-line therapy for individuals aged 18 years and older; Nyvepria moved from first-line to second-line for individuals younger than 18, and from second-line to third-line for individuals aged 18 years and older, effective July 1, 2025.
04Billing team: code 92972 now requires review for investigational, effective March 5, 2025.
05Billing team: codes 25448, 0224U, 86328, 86413 and 86769 no longer require review, effective March 1, 2025, and the SARS-CoV-2 Serology (Antibody) Testing policy 2.04.518 was archived.
Codes mentioned
9297225448863288641386769
Original notice
Medical Policy and Coding Updates - March 2025
premera.com · Always check the source before changing claims.
Related changes
See all Premera Blue Cross changes →Medical Policy and Coding Updates - June 2020MediumNo effective date · Medical PolicyMedical Policy and Coding Updates - January 2025HighNo effective date · Medical PolicyMedical Policy and Coding Updates - October 2020MediumNo effective date · Medical PolicyMedical Policy and Coding Updates - December 2024HighNo effective date · Medical PolicyBrowse every Premera Blue Cross change in the policy list