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 Oct 20, 2025.

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CommercialPrior AuthMedium impact

08.01.21h, Blinatumomab (Blincyto®)

Independence Blue Cross·Oncology, Hematology·Pharmacy

Effective date

Oct 20, 2025

We identified it

Jun 19, 2026

Days to comply

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Summary

The policy for Blinatumomab (Blincyto®) has been updated with changes to medical necessity criteria, medical coding requirements, and general guidelines. This affects pharmacy coverage and billing procedures for this specialty oncology medication used primarily in hematology/oncology practices.

Action Required

Action needed

By October 20, 2025: Billing team and providers must review updated medical necessity criteria and coding requirements for Blinatumomab (Blincyto®). Update prior authorization workflows and ensure documentation meets new medical necessity standards. Verify correct HCPCS coding procedures are being followed for this specialty oncology drug.

Related policy hubs

Independence Blue Cross policies Oncology Hematology