Medicare AdvantageCoverageMedium impact
MA08.130h, Filgrastim (Neupogen®) and Related Biosimilars, and Tbo-filgrastim (Granix®)
Independence Blue Cross·Oncology, Hematology, Infectious Disease·Pharmacy
Effective date
Apr 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.130h regarding Filgrastim (Neupogen®), related biosimilars, and Tbo-filgrastim (Granix®) has been updated effective April 1, 2025. This is a fresh pharmacy policy update that may affect coverage and billing requirements for these specific medications used to stimulate white blood cell production.
Action Required
By April 1, 2025: Billing team should review the full policy details at the provided URL to understand specific changes to Filgrastim, biosimilar, and Tbo-filgrastim coverage requirements for Medicare Advantage patients. Update billing procedures and prior authorization workflows as specified in the complete policy document.