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Independence Blue CrossCommercial · Coverage · Pharmacy · Rheumatology, Pharmacy, Internal MedicineMedium impact

08.01.15i, Golimumab and Related Biosimilars for Intravenous Infusion

Effective date
Oct 19, 2026
Identified
Oct 20, 2026

Summary

Independence Blue Cross updated policy 08.01.15i effective 10/19/2026 to add Immgolis Intri™ (golimumab-sldi), the first FDA-approved biosimilar to Simponi Aria, and removed the DMARD prerequisite for ankylosing spondylitis treatment. Billing teams must recognize two new HCPCS codes (C9399 and J3590) for the biosimilar and update prior authorization workflows to reflect the revised AS/r-axSpA criteria.

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What to do

Action · 4 steps
01Effective 10/19/2026: Billing team must update the practice's billing system and prior authorization templates to recognize HCPCS codes C9399 and J3590 for Immgolis Intri™ (golimumab-sldi) claims.
02Verify that the practice's medical necessity criteria for ankylosing spondylitis/radiographic axial spondyloarthritis (r-axSpA) no longer require DMARD prerequisite documentation, per the updated 2026 ACR/SAA/SPARTAN alignment—only document failure, contraindication, or intolerance to a 4-week trial of two NSAIDs at maximum recommended or tolerated anti-inflammatory dose, plus TB exclusion.
03Update prior authorization decision rules in IBX submissions to reflect the simplified AS/r-axSpA pathway.
04Providers and clinical staff should be informed that the biosimilar Immgolis Intri™ is now available as an interchangeable alternative to Simponi Aria.

Codes mentioned

J1602C9399J3590

Original notice

08.01.15i, Golimumab and Related Biosimilars for Intravenous Infusion
medpolicy.ibx.com · Always check the source before changing claims.
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Related policy hubs

Independence Blue Cross policiesRheumatologyPharmacyInternal MedicineCode J1602Code C9399Code J3590

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