CommercialCoverageMedium impact
08.01.81e, Tafasitamab-cxix (Monjuvi®)
Independence Blue Cross·Hematology, Oncology, Pharmacy·Pharmacy
Effective date
Aug 18, 2025
We identified it
Jun 19, 2026
Summary
Policy 08.01.81e for Tafasitamab-cxix (Monjuvi®) has been updated effective August 18, 2025, with changes to medical necessity criteria, medical coding requirements, and general guidelines. The billing team must review updated coverage rules, coding requirements, and prior authorization processes for this specialty pharmacy medication used in hematologic malignancies.
Action Required
By August 18, 2025: Billing team must obtain and review the complete policy text from the provided URL to identify specific medical necessity criteria, updated HCPCS codes (if any), and prior authorization requirements for Tafasitamab-cxix claims. Update billing system rules and prior authorization workflows accordingly. Pharmacy staff should communicate updated coverage guidelines to prescribers. NOTE: Specific billing codes and detailed requirements are not visible in the policy metadata provided—direct access to the full policy document at https://medpolicy.ibx.com/ibc/Commercial/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=08&FilterField2=MPSiteActivityLogYear&FilterValue2=2025#commercial-08-01-81e is required to extract actionable coding and documentation changes.