Medicare AdvantageCoverageMedium impact
MA08.018l, Trastuzumab (Herceptin®) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.018l for Trastuzumab (Herceptin) and related biosimilars has been updated with changes to coverage and/or reimbursement positions. This affects cancer treatment billing for trastuzumab medications and biosimilars including Herceptin Hylecta.
Action Required
Before January 1, 2026: Billing team must review updated coverage and reimbursement requirements for trastuzumab (Herceptin) and biosimilar medications. Access the full policy at the provided URL to determine specific billing changes, prior authorization requirements, or documentation needs. Update billing protocols and inform oncology providers of any new requirements.