← Back to list
Pharmacy Policy Updates
Act
by Jan 1, 2026
Effective date
Jan 1, 2026
Identified
Jun 19, 2026
Summary
BCBS North Dakota updated medical pharmacy billing codes effective January 1, 2026, adding 7 new HCPCS J-codes for new drugs and deleting 4 discontinued codes. Retail pharmacy prior authorization requirements were also updated for biologic immunomodulators and other specialty medications effective February 1, 2026.
Get alerts when payers change rules like this one
We check Blue Cross Blue Shield of North Dakota and other payers every day and email you when a change matches your specialty and state.
Get Blue Cross Blue Shield of North Dakota alertsPolicy Monitoring is free. No card required.
What to do
by Jan 1, 2026 · 2 steps
01Billing team must update billing software to include new J-codes (J9282, Q5160, J9184, J3389, J9256, J9326, J3387) and remove discontinued codes (J9019, J1572, J0172, J1562).
02By February 1, 2026: Update prior authorization requirements for biologic immunomodulators, Hepatitis C antivirals, and Zeposia - verify new failure requirements and pediatric weight restrictions before submitting claims.
Codes mentioned
J9282Q5160J9184J3389J9256J9326J3387J9019J1572J0172J1562
Original notice
Pharmacy Policy Updates
bcbsnd.com · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of North Dakota changes →Pharmacy Policies Available OnlineMediumEffective Sep 9, 2026 · PharmacyPharmacy Policy UpdatesHighNo effective date · PharmacyPharmacy Policy UpdatesHighEffective Jul 1, 2026 · PharmacyPharmacy Policy UpdatesMediumEffective Oct 1, 2025 · PharmacyBrowse every Blue Cross Blue Shield of North Dakota change in the policy list