Who is affected by this change?

This affects Independence Blue Cross Oncology, Hematology providers on Commercial plans.

When does this change take effect?

This change is effective Dec 29, 2025.

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CommercialCoverageMedium impact

08.01.07k, Pertuzumab (Perjeta®)

Independence Blue Cross·Oncology, Hematology·Pharmacy

Effective date

Dec 29, 2025

We identified it

Jun 19, 2026

Days to comply

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Summary

Independence Blue Cross updated medical necessity criteria and medical coding requirements for Pertuzumab (Perjeta®), a cancer medication used in oncology practices. This pharmacy policy change affects how the drug is prescribed, documented, and billed.

Action Required

Action needed

By December 29, 2025: Oncology providers and billing teams must review updated medical necessity criteria for Pertuzumab (Perjeta®) prescriptions. Update documentation templates to ensure compliance with new criteria and verify any coding changes in billing system. Review full policy details at the source URL to identify specific requirements.

Related policy hubs

Independence Blue Cross policies Oncology Hematology