When does this change take effect?

This change is effective Aug 6, 2025.

CommercialCoverageMedium impact

08.00.22q, Palivizumab (Synagis®)

Q: Who is affected by this change?

This affects Independence Blue Cross Pediatrics, Pulmonology, Family Medicine, Internal Medicine providers on Commercial plans.

Independence Blue Cross·Pediatrics, Pulmonology, Family Medicine +1 more·Pharmacy

Effective date

Aug 6, 2025

We identified it

Jun 19, 2026

Days to comply

—

Summary

The Palivizumab (Synagis®) pharmacy policy has been reissued and updated for commercial plans, effective August 6, 2025. This is a very recent policy change that may affect coverage, prior authorization, or billing requirements for this respiratory syncytial virus (RSV) prevention medication.

Action Required

Action needed

By August 6, 2025: Billing team must review the updated Palivizumab (Synagis®) policy at the provided URL to identify specific changes to prior authorization requirements, coverage criteria, or billing procedures for commercial plans. Update billing protocols and staff training accordingly to ensure compliance with the new policy requirements.

Related policy hubs

Independence Blue Cross policies Pediatrics Pulmonology Family Medicine Internal Medicine