Medicare AdvantageCoverageMedium impact
MA08.138e, Tafasitamab-cxix (Monjuvi®)
Independence Blue Cross·Oncology, Hematology, Pharmacy·Pharmacy
Effective date
Aug 18, 2025
We identified it
Jun 19, 2026
Summary
Policy MA08.138e updates medical necessity criteria, medical coding guidelines, and general informational content for Tafasitamab-cxix (Monjuvi®), an oncology pharmaceutical. The billing team must review updated coverage criteria and coding requirements to ensure proper claim submission and prior authorization compliance for this drug effective August 18, 2025.
Action Required
By August 18, 2025: Billing team and providers must review the complete MA08.138e policy text at the provided URL to identify specific medical necessity criteria, approved billing codes, and prior authorization requirements for Tafasitamab-cxix (Monjuvi®). Update billing system rules, prior authorization workflows, and provider documentation templates to reflect new medical necessity criteria. Communicate updated requirements to all clinical staff. Claims submitted without compliance to updated medical necessity criteria or coding guidelines will be subject to denial or reconsideration.