Medicare AdvantageCoverageMedium impact
MA08.086d, Nusinersen (Spinraza®)
Independence Blue Cross·Neurology, Pediatrics·Pharmacy
Effective date
Nov 12, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.086d for Nusinersen (Spinraza®) has been reissued with an effective date of November 12, 2025. This is a pharmacy policy update that may affect coverage criteria, prior authorization requirements, or billing procedures for this spinal muscular atrophy treatment.
Action Required
Before November 12, 2025: Billing team should review the updated MA08.086d policy for Nusinersen (Spinraza®) to identify any changes to coverage criteria, prior authorization requirements, or billing procedures. Monitor for detailed policy content when available and update billing protocols accordingly for Medicare Advantage plans.