Medicare AdvantagePrior AuthMedium impact
MA08.148c, Amivantamab-vmjw (Rybrevant®) and Amivantamab and hyaluronidase-lpuj (Rybrevant Faspro™)
Independence Blue Cross·Oncology·Pharmacy
Effective date
Apr 20, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.148c for Amivantamab-vmjw (Rybrevant®) and Amivantamab and hyaluronidase-lpuj (Rybrevant Faspro™) has been updated with changes to medical necessity criteria, medical coding, and general guidelines. This affects billing and coverage requirements for these specialty oncology medications.
Action Required
By April 20, 2026: Billing team must review updated medical necessity criteria and coding guidelines for Amivantamab-vmjw (Rybrevant®) and Amivantamab and hyaluronidase-lpuj (Rybrevant Faspro™). Update prior authorization requirements and documentation protocols in billing system. Notify oncology providers of any new medical necessity requirements to ensure proper documentation before drug administration.