CommercialPrior AuthMedium impact
08.00.90t, Paclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound)/(Abraxane® for Injectable Suspension)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Jul 28, 2025
We identified it
Jun 19, 2026
Summary
Updated medical necessity criteria for Paclitaxel Protein-Bound Particles (Abraxane) injectable suspension. This affects prior authorization requirements and coverage determinations for this oncology medication used in cancer treatment.
Action Required
By July 28, 2025: Review and update prior authorization workflows for Abraxane (paclitaxel protein-bound particles) prescriptions. Billing team must verify new medical necessity criteria are met before submitting claims. Oncology staff should review documentation requirements to ensure compliance with updated criteria.