Medicare AdvantageCoverageMedium impact
MA08.120f, Nivolumab (Opdivo®), Nivolumab and Hyaluronidase-nvhy (Opdivo Qvantig™)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Jul 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.120f for Nivolumab (Opdivo®) and Nivolumab with Hyaluronidase-nvhy (Opdivo Qvantig™) has been updated with new coverage criteria. This affects billing for these cancer immunotherapy drugs under Medicare Advantage plans.
Action Required
Before July 1, 2025: Billing team must review updated coverage criteria for Nivolumab (Opdivo) and Nivolumab with Hyaluronidase-nvhy (Opdivo Qvantig) under Medicare Advantage plans. Update prior authorization workflows and verify current coverage requirements with the full policy document at the provided URL.