CommercialCoverageHigh impact
08.01.29n, Daratumumab (Darzalex®), Daratumumab and Hyaluronidase-fihj (Darzalex Faspro®)
Independence Blue Cross·Hematology, Oncology, Pharmacy·Pharmacy
Effective date
Aug 24, 2026
We identified it
Aug 25, 2026
Summary
Insurance policy 08.01.29n addresses coverage and medical necessity criteria for Daratumumab (Darzalex®) and Daratumumab with Hyaluronidase-fihj (Darzalex Faspro®). This is a fresh policy update effective 08/24/2026 that may include changes to coverage determinations, reimbursement positions, or medical necessity guidelines for these monoclonal antibody therapies used in hematologic malignancies.
Action Required
By 08/24/2026: Billing and clinical teams must obtain and review the complete policy text from the source URL to identify specific medical necessity criteria, prior authorization requirements, and covered indications for Daratumumab products. Update billing system rules, prior authorization templates, and provider education materials accordingly. Contact the payer (IBX) directly if specific billing codes or documentation requirements are not clear in the posted policy. Verify coverage status before dispensing or administering these medications to avoid claim denials.