Medicare AdvantageCoverageMedium impact
MA08.022s, Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®)
Independence Blue Cross·Oncology, Rheumatology, Hematology +1 more·Pharmacy
Effective date
Oct 29, 2025
We identified it
Jun 19, 2026
Summary
This is a reissue of policy MA08.022s regarding Rituximab (Rituxan®) infusion, related biosimilars, and Rituxan Hycela® (subcutaneous injection). The policy became effective on 10/29/2025. The billing team must review the complete policy text to identify specific coverage criteria, prior authorization requirements, billing codes, and any changes from the previous version to ensure compliant claims submission.
Action Required
By 11/15/2025: Billing team must obtain and review the complete policy text at the provided URL to identify: (1) specific CPT/HCPCS codes for rituximab administration and biosimilars, (2) prior authorization requirements, (3) coverage criteria by diagnosis, and (4) any changes from the prior version. Update billing software, encounter forms, and prior authorization protocols accordingly. Pharmacy and clinical staff should be notified of any coverage restrictions. Failure to implement policy requirements will result in claim denials and rework.