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Independence Blue CrossMedicare Advantage · Billing Codes · Pharmacy · Dermatology, Rheumatology, Allergy & Immunology +1 moreMedium impact

MA08.007av, Medicare Part B vs. Part D Crossover Drugs

Act
by Jun 15, 2026
Effective date
Jun 15, 2026
Identified
Jul 7, 2026

Summary

Independence Blue Cross updated Medicare Advantage policy MA08.007av to MA08.007ay, removing a JB modifier requirement for Skyrizi (risankizumab-rzaa) subcutaneous injections and adding Nemluvio (nemolizumab-ilto) to the Part D-only drugs list (excluded from Part B coverage). These changes clarify billing and coverage for self-administered biologic drugs under Medicare Advantage plans.

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What to do

by Jun 15, 2026 · 5 steps
01Billing team must update billing software to REMOVE the JB modifier requirement when submitting Skyrizi (risankizumab-rzaa) claims using HCPCS codes C9399, J3490, or J3590 for subcutaneous administration.
02Update claims processing rules to ensure Nemluvio (nemolizumab-ilto) claims with C9399, J3490, or J3590 are routed to Part D pharmacy benefits, NOT Part B medical benefits.
03Verify that EMR/billing templates no longer flag these drugs for Part B processing.
04Failure to implement changes may result in claim denials or incorrect benefit routing, requiring rework and delayed reimbursement.
05Communicate changes to providers and prior authorization staff.

Codes mentioned

C9399J3490J3590

Original notice

MA08.007av, Medicare Part B vs. Part D Crossover Drugs
medpolicy.ibx.com · Always check the source before changing claims.
View original ↗

Related changes

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Related policy hubs

Independence Blue Cross policiesDermatologyRheumatologyAllergy & ImmunologyPharmacyCode C9399Code J3490Code J3590

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