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 Aug 18, 2025.

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CommercialCoverageMedium impact

08.01.81e, Tafasitamab-cxix (Monjuvi®)

Independence Blue Cross·Oncology, Hematology·Pharmacy

Effective date

Aug 18, 2025

We identified it

Jun 19, 2026

Days to comply

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Summary

Policy 08.01.81e for Tafasitamab-cxix (Monjuvi®) has been updated with changes to medical necessity criteria, medical coding requirements, and general guidelines. This affects billing and coverage determinations for this specialty oncology medication used in lymphoma treatment.

Action Required

Action needed

By August 18, 2025: Billing team and oncology providers must review updated medical necessity criteria and coding requirements for Tafasitamab-cxix (Monjuvi®) at the source URL. Update prior authorization workflows and documentation requirements in billing system. Ensure claims meet new medical necessity criteria to avoid denials.

Related policy hubs

Independence Blue Cross policies Oncology Hematology