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 Mar 24, 2025.

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CommercialCoverageMedium impact

08.02.12b, Epcoritamab-bysp (EPKINLY®)

Independence Blue Cross·Oncology, Hematology·Pharmacy

Effective date

Mar 24, 2025

We identified it

Jun 19, 2026

Days to comply

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Summary

The policy for Epcoritamab-bysp (EPKINLY®), a pharmacy medication, has been updated with changes to medical necessity criteria, medical coding requirements, and general guidelines. This affects how the drug will be prescribed, coded, and billed for commercial insurance plans.

Action Required

Action needed

By March 24, 2025: Billing team must review the updated policy at the provided URL to understand new medical necessity criteria and coding requirements for Epcoritamab-bysp (EPKINLY®). Update billing procedures and documentation requirements according to the new guidelines. Providers should be notified of any changes to prescribing or documentation requirements.

Related policy hubs

Independence Blue Cross policies Oncology Hematology