CommercialCoverageMedium impact
08.01.90b, Amivantamab-vmjw (Rybrevant®)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Jul 28, 2025
We identified it
Jun 19, 2026
Summary
Policy 08.01.90b for Amivantamab-vmjw (Rybrevant®) has been updated with changes to medical necessity criteria, medical coding, and general guidelines. This affects billing and coverage requirements for this specialty oncology medication used in lung cancer treatment.
Action Required
By July 28, 2025: Billing team must review updated medical necessity criteria for Amivantamab-vmjw (Rybrevant®) and update prior authorization procedures accordingly. Oncology providers should verify documentation requirements meet new criteria before submitting claims. Update billing system notes with new coding guidelines to prevent claim denials.