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06.03.04p, Apheresis Therapy

Independence Blue Cross·Hematology, Oncology, Nephrology +2 more·Medical Policy
Effective date
Jun 8, 2026
We identified it
Jun 19, 2026
Days to comply

Summary

The apheresis therapy policy has updated medical necessity criteria that will affect coverage determinations for therapeutic apheresis procedures. This change modifies the clinical requirements that must be met for these treatments to be considered medically necessary and covered.

Action Required

Action needed
Before June 8, 2026: Clinical teams must review updated medical necessity criteria for apheresis therapy and ensure documentation meets new requirements. Update EMR templates and prior authorization workflows to align with revised criteria. Claims may be denied if new medical necessity standards are not met.