Medicare AdvantageCoverageMedium impact
MA08.108f, Polatuzumab vedotin-piiq (Polivy®)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Dec 29, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage plans have updated medical necessity criteria for Polatuzumab vedotin-piiq (Polivy®), a cancer medication. The billing team needs to review new coverage requirements and documentation standards for this specialty oncology drug.
Action Required
By December 29, 2025: Billing team must review updated medical necessity criteria for Polatuzumab vedotin-piiq (Polivy®) at the source URL. Update prior authorization procedures and documentation requirements for Medicare Advantage patients receiving this oncology medication. Ensure providers document medical necessity per new criteria to prevent claim denials.