Medicare AdvantagePrior AuthLow impact
Revcovi (elapegademase-lvlr) (New)
Humana·Allergy & Immunology, Pediatrics, Internal Medicine·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
New prior authorization policy for Revcovi (elapegademase-lvlr) effective January 1, 2026 for Medicare Advantage plans. This medication treats a rare immune deficiency (ADA-SCID) and requires diagnosis confirmation for approval.
Action Required
Before January 1, 2026: Billing team must update prior authorization system to require approval for Revcovi (elapegademase-lvlr) for Medicare Advantage patients. Providers treating ADA-SCID patients must submit diagnosis documentation to obtain authorization. Claims will be denied without prior authorization.