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Independence Blue CrossMedicare Advantage · Coverage · Pharmacy · Rheumatology, Allergy & Immunology, Oncology +1 moreMedium impact

MA08.070h, Golimumab and Related Biosimilars for Intravenous Infusion

Effective date
Oct 19, 2026
Identified
Oct 20, 2026

Summary

Independence Blue Cross updated MA08.070h to add golimumab-sldi (Immgolis Intri™), the first FDA-approved interchangeable biosimilar to Simponi Aria®, effective 10/19/2026. The policy also removed the DMARD prerequisite for ankylosing spondylitis/radiographic axial spondyloarthritis (AS/r-axSpA) treatment, aligning with 2026 ACR/SAA/SPARTAN guidelines. Billing teams must recognize the new biosimilar using HCPCS codes C9399 and J3590 when claims are submitted.

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What to do

Action · 4 steps
01Effective 2026-10-19: Billing team should update billing system and claim submission workflows to recognize and process claims for golimumab-sldi (Immgolis Intri™) using HCPCS codes C9399 (Unclassified drugs or biologicals) and J3590 (Unclassified biologics) as alternatives to J1602 (golimumab intravenous).
02Verify that authorization systems reflect the updated AS/r-axSpA criteria, which now require documentation of failure, contraindication, or intolerance to at least 4 weeks of two NSAIDs at maximum dose (DMARD prerequisite has been removed per 2026 ACR/SAA/SPARTAN guidelines).
03Confirm that all prior authorization requests and claim denials reference the current coverage criteria and no longer require DMARD trial documentation for AS/r-axSpA cases.
04This applies to Independence Blue Cross Medicare Advantage members only; review member benefits to confirm whether golimumab intravenous products are covered under medical (Part B) or pharmacy (Part D) benefits.

Codes mentioned

J1602C9399J3590

Original notice

MA08.070h, Golimumab and Related Biosimilars for Intravenous Infusion
medpolicy.ibx.com · Always check the source before changing claims.
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Related changes

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Related policy hubs

Independence Blue Cross policiesRheumatologyAllergy & ImmunologyOncologyPharmacyCode J1602Code C9399Code J3590

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