When does this change take effect?

This change is effective Apr 1, 2026.

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Medicare AdvantageCoverageMedium impact

MA08.179a, Guselkumab (Tremfya®) Injection for Intravenous Use

Q: Who is affected by this change?

This affects Independence Blue Cross Dermatology, Rheumatology, Gastroenterology providers on Medicare Advantage plans.

Independence Blue Cross·Dermatology, Rheumatology, Gastroenterology·Pharmacy

Effective date

Apr 1, 2026

We identified it

Jun 19, 2026

Days to comply

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Summary

Medicare Advantage policy MA08.179a for Guselkumab (Tremfya®) injection for intravenous use has been reissued. This is a pharmacy policy update that will take effect April 1, 2026, potentially affecting coverage or administration requirements for this specialty injectable medication.

Action Required

Action needed

Before April 1, 2026: Billing team should review the full policy details at the provided URL to understand specific coverage changes for Guselkumab (Tremfya®) injections. Update billing procedures and prior authorization requirements as specified in the complete policy document.

Related policy hubs

Independence Blue Cross policies Dermatology Rheumatology Gastroenterology