Medicare AdvantageCoverageMedium impact
MA08.093q, Chimeric Antigen Receptor (CART) Therapy: Yescarta Tecartus, Breyanzi, Kymriah and Aucatzyl
Independence Blue Cross·Oncology, Hematology·Medical Policy
Effective date
Feb 9, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.093q has been updated with changes to medical necessity criteria, medical coding, and general guidelines for CAR-T cell therapies including Yescarta, Tecartus, Breyanzi, Kymriah and Aucatzyl. This affects billing and coverage requirements for these specialized cancer treatments.
Action Required
Before February 9, 2026: Billing team must review updated medical necessity criteria and coding guidelines for CAR-T therapies (Yescarta, Tecartus, Breyanzi, Kymriah, Aucatzyl). Update prior authorization processes and documentation requirements in billing system. Ensure providers are aware of revised criteria to prevent claim denials.