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Medicare AdvantageCoverageMedium impact

MA08.130g, Filgrastim (Neupogen®) and Related Biosimilars, and Tbo-filgrastim (Granix®)

Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

Medicare Advantage policy MA08.130g for Filgrastim (Neupogen®), related biosimilars, and Tbo-filgrastim (Granix®) has been updated effective January 1, 2025. This affects coverage and billing for these white blood cell growth medications commonly used in oncology and hematology practices.

Action Required

Action needed
By January 15, 2025: Billing team must review the complete policy at the source URL to identify specific changes to coverage criteria, prior authorization requirements, or billing guidelines for Filgrastim, biosimilars, and Tbo-filgrastim. Update billing system and provider workflows accordingly based on the detailed policy requirements.