Medicare AdvantageCoverageMedium impact
MA08.168a, Elranatamab-bcmm (Elrexfio®)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
May 4, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.168a for Elranatamab-bcmm (Elrexfio®) has been updated with changes to medical necessity criteria, medical coding, and general guidelines. This affects pharmacy coverage and billing requirements for this specialty oncology medication used to treat multiple myeloma.
Action Required
By May 4, 2026: Review updated medical necessity criteria for Elranatamab-bcmm (Elrexfio®) prescriptions. Billing team must verify any new prior authorization requirements and update documentation requirements in system. Oncology providers should review new coding guidelines and ensure proper medical necessity documentation is in place before prescribing.