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4/1/2025
04/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products
The intent of this document is to communicate Commercial Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 04/01/2025, unless otherwise noted. 

For more information related to these services, please refer to specific policies when applicable.​​​​​​​​

0.104/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Productse642f42d-c0cd-4fe1-9cdf-f992a59c6e76
12/23/2024
Coverage Expansion of Respiratory Syncytial Virus Vaccine (Abrysvo) for Commercial Members (Retroactively Effective October 22, 2024)
The purpose of this communication is to provide notice regarding the updated coverage criteria for respiratory syncytial virus vaccine (Abrysvo) retroactively effective to October 22, 2024 for Commercial members. ​
0.1Coverage Expansion of Respiratory Syncytial Virus Vaccine (Abrysvo) for Commercial Members (Retroactively Effective October 22, 2024)f05014dc-7a85-4ece-817d-bc8af057c54d
10/8/2024
10/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products (Updated October 8, 2024)
The intent of this document is to communicate Commercial Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 10/01/2024, unless otherwise noted.

For more information related to these services, please refer to specific policies when applicable.​​​​​​

0.110/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products (Updated October 8, 2024)5e7a395d-fcdb-44bc-8fcf-b457bd4efe4b
8/28/2024
New Preventive Coverage of 21-valent Pneumococcal Vaccine and Updated Preventive Coverage for Respiratory Syncytial Virus Vaccines for Commercial Members (Retroactively effective to June 7, 2024)
The purpose of this communication is to provide notice regarding the updated coverage criteria for respiratory syncytial virus vaccines and new coverage criteria for 21-valent pneumococcal vaccine for Commercial members.  Services covered are retroactively effective to June 7, 2024.​
0.1New Preventive Coverage of 21-valent Pneumococcal Vaccine and Updated Preventive Coverage for Respiratory Syncytial Virus Vaccines for Commercial Members (Retroactively effective to June 7, 2024)d62fa3ff-a812-4a30-ab0d-859b1e151ddd
8/5/2024
Coverage of Cantharidin (Ycanth) Topical Solution for Commercial Products (Retroactively Effective to 04/01/2024)
​The purpose of this document is to communicate that the Company has revised its coverage position for cantharidin (Ycanth)​ topical solution.  

The coverage position for cantharidin (Ycanth)​, represented by HCPCS code J7354, has been revised from non-covered to medically necessary.  This medically necessary coverage position is retroactively effective for dates of service beginning 04/01/2024. 


0.1Coverage of Cantharidin (Ycanth) Topical Solution for Commercial Products (Retroactively Effective to 04/01/2024)bb1ec27b-850e-469c-bd6b-4f00205c1f4a
7/3/2024
Pemivibart (Pemgarda) for Pre-Exposure Prophylaxis for Coronavirus Disease 2019 (COVID-19) for Commercial Members
The purpose of this document is to communicate the Company's coverage position for pemivibart (Pemgarda, Invivyd​, Inc.) for pre-exposure prophylaxis for Coronavirus disease 2019 (COVID-19) for Commercial members.  Coverage for pre-exposure prophylaxis for Coronavirus disease 2019 (COVID-19) for Commercial members​ is retroactively effective to March 22, 2024.

​


0.1Pemivibart (Pemgarda) for Pre-Exposure Prophylaxis for Coronavirus Disease 2019 (COVID-19) for Commercial Memberse3a12362-7045-4a36-ad6e-2c1ffce333e9
7/1/2024
Coverage for Low Frequency Ultrasound Treatment for Wound Management for Commercial Members

The purpose of this communication is to provide advance notice regarding the change of coverage determination for low frequency ultrasound for wound management for our Commercial Members.  This change will become effective on October 1, 2024.  Low frequency ultrasound for wound management, represented by CPT code 97610, will be added to Policy #12.01.01bn: Experimental/Investigational Services, effective October 1, 2024.
 



1Coverage for Low Frequency Ultrasound Treatment for Wound Management for Commercial Members64e2d9a2-e0e2-481f-b90d-53ff4150cea5
4/1/2024
4/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products
The intent of this document is to communicate Commercial Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 04/01/2024, unless otherwise noted. For more information related to these services, please refer to specific policies when applicable.​​​​​​​
0.14/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Productsb96170eb-dc2e-4de8-b2ca-4f909772323b
12/29/2023
1/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products
The intent of this document is to communicate Commercial Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 01/01/2024, unless otherwise noted. For more information related to these services, please refer to specific policies when applicable.​​​​​​​
0.11/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products909de290-c38e-482a-8045-e2b79aa51749
12/15/2023
Coverage of Meningococcal ABCWY vaccine and Smallpox and Mpox Vaccine for Independence Commercial Members (Retroactively Effective to October 26, 2023)
Retroactively effective to October 26, 2023, the purpose of this communication is to provide notice regarding the coverage criteria for meningococcal groups A, B, C, W, and Y vaccine (Penbraya) and smallpox and mpox vaccine, live, non-replicating (Jynneos) vaccine for Independence Commercial members.​
0.1Coverage of Meningococcal ABCWY vaccine and Smallpox and Mpox Vaccine for Independence Commercial Members (Retroactively Effective to October 26, 2023)4d83d901-88bb-4142-bd8d-fd6db9a7fafd
5/12/2023
Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for Independence Commercial Members (Updated May 12, 2023)

The purpose of this communication is to provide notice regarding information and procedure codes related to testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for Independence commercial members. Additionally, this Company document identifies when coverage is provided for clinical purposes, and the nonco​vered instances such as public health surveillance and screening. 




0.1Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for Independence Commercial Members (Updated May 12, 2023)89689bbb-5b37-4282-b90a-69b3d315792d
1/4/2021
1/1/2021 CPT & HCPCS Annual Code Update Coverage Determinations for Commercial Products
The intent of this document is to communicate Commercial Product coverage determinations for services identified through the Annual Code Update process. 
01/1/2021 CPT & HCPCS Annual Code Update Coverage Determinations for Commercial Productsb976b7b6-ff87-4f04-a559-d2f8805e0586
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Independence Blue Cross is a subsidiary of Independence Health Group, Inc. — independent licensees of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.