CommercialCoverageMedium impact
08.01.43p, Chimeric Antigen Receptor (CAR) Therapy
Independence Blue Cross·Oncology, Hematology·Medical Policy
Effective date
Feb 24, 2025
We identified it
Jun 19, 2026
Summary
Policy 08.01.43p establishes medical necessity criteria for Chimeric Antigen Receptor (CAR) Therapy coverage. The billing team must ensure claims meet new coverage requirements and documentation standards. This is a recent policy effective 02/24/2025 that supersedes any prior CAR therapy guidance.
Action Required
By 02/24/2025: Billing team must obtain and review the complete CAR Therapy policy 08.01.43p to identify specific medical necessity criteria, prior authorization requirements, and covered indications. Coordinate with oncology providers to ensure all CAR therapy claims include required clinical documentation (disease type, treatment history, patient eligibility criteria) before submission. Update claim submission procedures and create internal checklist for CAR therapy cases to prevent denials. Contact payer at https://medpolicy.ibx.com/ibc/Commercial/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=02&FilterField2=MPSiteActivityLogYear&FilterValue2=2025#commercial-08-01-43p if specific procedure codes or documentation templates are needed. Flag all pending CAR therapy claims for review against new criteria.