Premera Blue Cross October 2023 Medical Policy Updates

Click here to view the Premera Blue Cross Medical Policy Updates »

• Adjunctive Techniques for Screening and Surveillance of Barrett Esophagus and Esophageal Dysplasia
• Amniotic Membrane and Amniotic Fluid
• Artificial Pancreas Device Systems
• Bioengineered Skin and Soft Tissue Substitutes
• C3 and C5 Complement Inhibitors
• Cellular Immunotherapy for Prostate Cancer
• CGRP Inhibitors for Migraine Prophylaxis
• Composite Tissue Allotransplantation of the Hand and Face
• Cranial Electrotherapy Stimulation and Auricular Electrostimulation
• Cryoablation of Tumors Located in the Kidney, Lung, Breast, Pancreas, or Bone
• Drugs for Rare Diseases
• Electrical Stimulation Devices
• Electronic Brachytherapy for Nonmelanoma Skin Cancer
• Epidermal Growth Factor Receptor (EGFR) Inhibitors
• Gender Transition/Affirmation Surgery and Related Services
• Hemlibra® (emicizumab-kxwh)
• Hyperthermic Intraperitoneal Chemotherapy HIPEC for Select Intra-Abdominal and Pelvic Malignancies
• IL-5 Inhibitors
• Immune Checkpoint Inhibitors
• Implantable Peripheral Nerve Stimulation for the Treatment of Chronic Pain
• Infertility and Assisted Reproduction Services
• Interferential Current Stimulation
• Kidney Transplant
• Magnetic Resonance–Guided Focused Ultrasound
• Medical Necessity Criteria for Pharmacy Edits
• Migraine and Cluster Headache Medications
• Miscellaneous Oncology Drugs
• Non-covered Experimental/Investigational Services
• Non-covered Services and Procedures
• Occipital Nerve Stimulation
• Peripheral Subcutaneous Field Stimulation
• Pharmacologic Treatment of Duchenne Muscular Dystrophy
• Pharmacotherapy of Multiple Sclerosis
• Pharmacotherapy of Spinal Muscular Atrophy (SMA)
• Prescription Digital Health Diagnostic Aid for Autism Spectrum Disorder
• Prescription Digital Therapeutics
• Prescription Digital Therapeutics for Attention Deficit/Hyperactivity Disorder
• Prescription Digital Therapeutics for Substance Use Disorder
• Preventive Care
• Prolotherapy
• Prostate Cancer Targeted Therapies
• Radicava® (edaravone)
• Repository Corticotropin Injection
• Rhinoplasty
• Therapeutic Radiopharmaceuticals in Oncology
• Transcatheter Arterial Chemoembolization (TACE) to Treat Primary or Metastatic Liver Malignancies
• Tumor Treating Fields Therapy
• Upper Gastrointestinal (UGI) Endoscopy for Adults
• Venclexta® venetoclax BCL-2 Inhibitor

Click here to view the Premera Blue Cross Medical Policy Updates »

Policy Alerts monitors Commercial and Medicare medical policies for changes. While Payers typically update medical policies annually, there are many reasons why a Payer might review or update a policy. When reviews occur out of cycle, they may go unnoticed. Policy Alerts keeps you informed of upcoming and unexpected coverage changes affecting your product. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on Payer decisions in real-time. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Save time and keep focused on the important Payer medical policy reviews and coverage decisions affecting your product!

Policy Alerts takes a client-focused hands-on approach and works hard to provide our customers with helpful insights and actionable analytics over raw data. We understand what our clients need and we are dedicated to making sure we provide timely, accurate and always up-to-date reports that can be used to implement and support a successful reimbursement strategy.

Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.