Medicare AdvantageCoverageMedium impact
MA08.058h, Blinatumomab (Blincyto®)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Oct 20, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.058h for Blinatumomab (Blincyto®) has been updated with changes to medical necessity criteria, medical coding requirements, and general guidelines. This affects billing and coverage requirements for this specialty oncology medication used primarily in cancer treatment.
Action Required
By October 20, 2025: Billing team must review updated medical necessity criteria for Blinatumomab (Blincyto®) claims for Medicare Advantage patients. Update prior authorization workflows and ensure documentation meets new requirements. Verify any coding changes are implemented in billing system to prevent claim denials.