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Medicare GLP-1 Bridge program: What prescribers need to know
Act
immediately
Effective date
Jul 1, 2026
Identified
Sep 2, 2026
Summary
Effective July 1, 2026, CMS launched the Medicare GLP-1 Bridge program, a demonstration program that expands access to select GLP-1 medications (Foundayo, Wegovy, Zepbound KwikPen) specifically for weight management outside of Medicare Part D coverage. Prescribers must include obesity diagnosis codes (E66 family) and annotate prescriptions with 'Send to bridge for weight management' to route claims correctly; prior authorization is required and triggered automatically after the initial claim denial.
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What to do
immediately · 5 steps
01Providers must update prescription writing processes to include (1) obesity diagnosis code from E66 family when prescribing covered GLP-1 medications for weight management, and (2) a note stating 'Send to bridge for weight management' on all such prescriptions.
02Billing and clinical staff must be trained that claims initially denied is expected and triggers CMS prior authorization.
03Providers must monitor for prior authorization requests from pharmacies via CoverMyMeds or fax within 24-72 hours and complete/submit authorization forms within that window.
04Failure to include 'bridge' notation will cause claims to route to standard Medicare Part D coverage, which does not cover GLP-1 for weight management and will be denied.
05Subsequent fills do not require re-authorization unless patient switches covered GLP-1 medications.
Codes mentioned
E66
Original notice
Medicare GLP-1 Bridge program: What prescribers need to know
uhcprovider.com · Always check the source before changing claims.