Medicare AdvantageCoverageMedium impact
MA08.148b, Amivantamab-vmjw (Rybrevant®)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Jul 28, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.148b for Amivantamab-vmjw (Rybrevant®) has been updated with changes to medical necessity criteria, medical coding requirements, and general guidelines. This oncology medication policy update affects billing and coverage determination processes.
Action Required
By July 28, 2025: Billing and clinical teams must review updated medical necessity criteria for Amivantamab-vmjw (Rybrevant®) prescriptions. Update prior authorization workflows and documentation requirements according to new guidelines. Ensure coding practices align with updated medical coding requirements to prevent claim denials.