Medicare AdvantageCoverageMedium impact
MA08.159c, Mirvetuximab soravtansine-gynx (Elahere®)
Independence Blue Cross·Oncology, OB-GYN·Pharmacy
Effective date
Jun 16, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.159c for Mirvetuximab soravtansine-gynx (Elahere®) has been updated with new medical necessity criteria and medical coding requirements. This affects billing and coverage determinations for this specialized oncology medication used in gynecologic cancers.
Action Required
Before June 16, 2025: Billing team and oncology providers must review updated medical necessity criteria and coding requirements for Mirvetuximab soravtansine-gynx (Elahere®). Access the full policy at the source URL to understand new documentation requirements and billing procedures. Update prior authorization processes and ensure compliance with new criteria to avoid claim denials.