Medicare AdvantageCoverageMedium impact
MA08.130g, Filgrastim (Neupogen®) and Related Biosimilars, and Tbo-filgrastim (Granix®)
Independence Blue Cross·Oncology, Hematology, Internal Medicine·Pharmacy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.130g for Filgrastim (Neupogen®) and related biosimilars, and Tbo-filgrastim (Granix®) has been updated effective January 1, 2025. This affects coverage and billing for white blood cell growth factors commonly used in oncology and hematology practices.
Action Required
Immediately: Review updated policy MA08.130g for Filgrastim (Neupogen®) and related biosimilars coverage criteria. Billing team should verify current prior authorization requirements and coverage guidelines for these medications in Medicare Advantage plans. Update billing protocols to ensure compliance with new policy effective January 1, 2025.