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MA08.172, Lifileucel (Amtagvi™)
Effective date
Not stated in the notice
Identified
Jun 19, 2026
Summary
This is a reissue with no changes to Independence Blue Cross Medicare Advantage policy MA08.172 for lifileucel (Amtagvi). The policy was reviewed and republished on 09/03/2025 to communicate the Company's continuing coverage position. No new billing requirements, codes, or coverage criteria have been modified since the original 10/21/2024 effective date.
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What to do
Action · 4 steps
01No immediate action required.
02This is a policy reissue with no changes to coverage criteria, billing codes, or documentation requirements.
03Billing team should file this reissue in the policy archive for reference.
04If your practice has not previously implemented billing for lifileucel (Amtagvi) under the original 10/21/2024 policy, refer to that foundational policy for initial setup requirements including prior authorization criteria verification.
Codes mentioned
C9399J3590C43.0C43.111C43.112C43.121C43.122C43.21C43.22C43.30C43.31C43.39
Original notice
MA08.172, Lifileucel (Amtagvi™)
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
See all Independence Blue Cross changes →MA08.172, Lifileucel (Amtagvi™)LowEffective Oct 21, 2024 · Pharmacy08.02.22, Lifileucel (Amtagvi™)LowEffective Oct 21, 2024 · Pharmacy08.02.22, Lifileucel (Amtagvi™)LowEffective Oct 21, 2024 · PharmacyMA08.070h, Golimumab and Related Biosimilars for Intravenous InfusionMediumEffective Oct 19, 2026 · PharmacyBrowse every Independence Blue Cross change in the policy list