CommercialCoverageMedium impact
08.01.90c, Amivantamab-vmjw (Rybrevant®) and Amivantamab and hyaluronidase-lpuj (Rybrevant Faspro™)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Apr 20, 2026
We identified it
Jun 19, 2026
Summary
This policy update affects coverage and medical necessity criteria for Amivantamab-vmjw (Rybrevant®) and Amivantamab and hyaluronidase-lpuj (Rybrevant Faspro™), which are cancer treatments primarily used for EGFR-mutated non-small cell lung cancer. The policy includes updates to medical coding, coverage criteria, and general guidelines for these specialty oncology medications.
Action Required
Before April 20, 2026: Oncology practices and billing teams must review updated medical necessity criteria for Amivantamab-vmjw (Rybrevant®) and Amivantamab and hyaluronidase-lpuj (Rybrevant Faspro™). Update prior authorization procedures and ensure documentation meets new coverage requirements. Review full policy at provided URL to understand specific billing code changes and coverage criteria.