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News & AnnouncementsPreventive Coverage Update of Human Papillomavirus (HPV) Screening for Commercial members (Retroactively effective 01/01/2025)5/4/2026
NotificationsIntravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists, VEGF Biosimilars, and Combination VEGF/Angiopoietin-2 (Ang-2) Inhibitors08.00.74ac5/4/2026 3:00 PM8/3/20265/4/2026Medical Necessity Criteria
Updated PoliciesHospital Readmissions00.01.47d4/1/2026 2:00 PM5/1/20265/1/2026Coverage and/or Reimbursement Position;General Description, Guidelines, or Informational Update
Updated PoliciesTalquetamab-tgvs (Talvey®)08.02.16a5/4/20265/4/2026Medical Necessity Criteria;Medical Coding
Updated PoliciesTeclistamab-cqyv (Tecvayli®)08.01.98d5/4/20265/4/2026Medical Necessity Criteria;Medical Coding
Updated PoliciesElranatamab-bcmm (Elrexfio®)08.02.18a5/4/20265/4/2026Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesRetifanlimab-dlwr (Zynyz®) 08.02.05d5/4/20265/4/2026Medical Necessity Criteria
Updated PoliciesPreventive Care Services00.06.02ay4/1/20265/5/2026Medical Necessity Criteria;Medical Coding5/5/2026
Updated PoliciesRoutine/Non-routine Vaccines08.01.04ai5/18/20265/18/2026Medical Necessity Criteria;Medical Coding
Coding UpdateTherapies for Spinal Muscular Atrophy Nusinersen (Spinraza®) and Onasemnogene abeparvovec-xioi (Zolgensma®)08.01.36g4/1/20265/6/2026
Coding UpdateRepair or Replacement of an External Prosthetic Device05.00.45l4/1/20265/14/2026