Medicare AdvantagePrior AuthMedium impact
Avastin J9035 Reminder
Blue Cross Blue Shield of Rhode Island·RI · Oncology, Ophthalmology·Physician / Facility
Effective date
Jan 1, 2023
We identified it
Jun 19, 2026
Summary
Avastin (J9035) requires prior authorization for Medicare members, which has been in effect since January 1, 2023, but was inadvertently omitted from the Prior Authorization for Drugs list. Providers with denying claims can contact the Provider Call Center for reprocessing.
Action Required
Immediately: Billing team must ensure prior authorization is obtained for all Avastin (J9035) claims for Medicare members before submission. Contact Provider Call Center to reprocess any previously denied claims. Update billing system and encounter forms to flag J9035 as requiring prior auth for Medicare patients.