CommercialCoverageMedium impact
08.01.73g, Filgrastim (Neupogen®) and Related Biosimilars, and tbo-filgrastim (Granix®)
Independence Blue Cross·Oncology, Hematology, Pharmacy·Pharmacy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Insurance policy 08.01.73g regarding Filgrastim (Neupogen®), biosimilars, and tbo-filgrastim (Granix®) became effective January 1, 2025. This is a new/updated pharmacy policy that may affect coverage, prior authorization requirements, or reimbursement for these colony-stimulating factor medications. The billing team must review the full policy text to identify specific coverage criteria, authorization requirements, and applicable billing codes.
Action Required
By January 31, 2025: Billing team must obtain and review the complete policy text at the provided URL (https://medpolicy.ibx.com/ibc/Commercial/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=01&FilterField2=MPSiteActivityLogYear&FilterValue2=2025#commercial-08-01-73g). Identify specific HCPCS codes for Filgrastim, biosimilars, and tbo-filgrastim, any prior authorization requirements, and coverage limitations. Update billing software and clinical staff with requirements. For any claims submitted for these medications on or after January 1, 2025 without compliance to new policy requirements, claims may be denied or delayed.