Who is affected by this change?

This affects Independence Blue Cross Oncology, Hematology providers on Medicare Advantage plans.

When does this change take effect?

This change is effective Apr 21, 2025.

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Medicare AdvantageCoverageMedium impact

MA08.182, Zanidatamab-hrii (Ziihera®)

Independence Blue Cross·Oncology, Hematology·Pharmacy

Effective date

Apr 21, 2025

We identified it

Jun 19, 2026

Days to comply

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Summary

A new Medicare Advantage policy MA08.182 has been established for Zanidatamab-hrii (Ziihera®), a pharmacy benefit drug. This creates new coverage guidelines for this oncology medication that will affect billing and prior authorization requirements.

Action Required

Action needed

By April 21, 2025: Billing team must review the full policy details at the source URL to understand coverage criteria and prior authorization requirements for Zanidatamab-hrii (Ziihera®). Update billing system with any new prior auth requirements and ensure providers are aware of coverage guidelines for this oncology medication.

Related policy hubs

Independence Blue Cross policies Oncology Hematology