| Updated Policies | Fam-trastuzumab deruxtecan-nxki (Enhertu®) | 08.00.12h | | 6/16/2025 | | | 6/16/2025 | Medical Necessity Criteria | | |
| Updated Policies | Trastuzumab (Herceptin®) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta) | 08.00.33t | | 6/16/2025 | | | 6/16/2025 | Medical Necessity Criteria;Medical Coding | | |
| Updated Policies | Autonomic Nervous System Testing | 07.03.23h | | 6/16/2025 | | | 6/16/2025 | Coverage and/or Reimbursement Position | | |
| Updated Policies | Mirvetuximab soravtansine-gynx (Elahere®) | 08.02.01c | | 6/16/2025 | | | 6/16/2025 | Medical Necessity Criteria | | |
| Updated Policies | Hyperthermic Intraperitoneal Chemotherapy for Select Intra-abdominal and Pelvic Malignancies | 11.00.13k | | 6/16/2025 | | | 6/16/2025 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Mosunetuzumab-axgb (Lunsumio™) | 08.02.00c | | 6/16/2025 | | | 6/16/2025 | Medical Necessity Criteria;Medical Coding | | |
| Updated Policies | Tisotumab vedotin-tftv (Tivdak®) | 08.01.83d | | 6/16/2025 | | | 6/16/2025 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Reimbursement for Radiopharmaceutical Agents | 09.00.32aj | | 4/1/2025 | | | 6/16/2025 | Medical Coding | | |
| Updated Policies | Efbemalenograstim alfa-vuxw (Ryzneuta®), Eflapegrastim-xnst (Rolvedon™), Pegfilgrastim (Neulasta®) and Related Biosimilars | 08.01.32n | | 6/16/2025 | | | 6/16/2025 | Medical Necessity Criteria;Medical Coding | | |
| Updated Policies | Nivolumab and Relatlimab-rmbw (Opdualag™) for intravenous use | 08.01.94d | | 6/16/2025 | | | 6/16/2025 | Medical Necessity Criteria | | |
| Updated Policies | Casgevy™ (exagamglogene autotemcel) | 08.02.14a | | 7/1/2025 | | | 6/30/2025 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | |
| Reissue Policies | Atidarsagene autotemcel (Lenmeldy) | 08.02.24 | | 12/23/2024 | 5/28/2025 | | 6/4/2025 | | | |
| Reissue Policies | Etranacogene dezaparvovec-drlb (Hemgenix®) | 08.02.03a | | 7/15/2024 | 5/28/2025 | | 6/4/2025 | | | |
| Reissue Policies | Trilaciclib (Cosela™) | 08.01.77e | | 10/21/2024 | 6/11/2025 | | 6/11/2025 | | | |
| Reissue Policies | Orthoptic/Pleoptic Training | 07.13.01k | | 7/15/2024 | 6/11/2025 | | 6/11/2025 | | | |
| Reissue Policies | Radioembolization for Primary and Metastatic Tumors of the Liver | 09.00.48h | | 10/1/2024 | 6/11/2025 | | 6/11/2025 | | | |
| Reissue Policies | Radium Ra 223 dichloride (Xofigo®) Injection (Independence Administrators) | 08.01.14e | | 3/1/2019 | 6/11/2025 | | 6/11/2025 | | | |
| Reissue Policies | Epidural, Paravertebral Facet, and Sacroiliac Joint Injections for Spinal Pain Management (Independence Administrators) | 11.15.23l | | 3/17/2025 | 6/11/2025 | | 6/11/2025 | | | |
| Reissue Policies | Brachytherapy and Accelerated Whole Breast Irradiation using Three-Dimensional Conformation Radiation Therapy | 09.00.10z | | 7/15/2019 | 6/11/2025 | | 6/11/2025 | | | |
| Reissue Policies | Intensity-Modulated Radiation Therapy (IMRT) (Independence Administrators) | 09.00.17q | | 11/6/2023 | 6/11/2025 | | 6/11/2025 | | | |
| Reissue Policies | Therapeutic Drug Monitoring for Antidepressants, Antipsychotics, or Antiepileptics | 06.02.55b | | 10/1/2024 | 6/25/2025 | | 6/25/2025 | | | |
| Reissue Policies | Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments | 06.02.44r | | 10/1/2024 | 6/25/2025 | | 6/25/2025 | | | |
| Coding Update | Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments | 06.02.44r | | 10/1/2024 | | | 6/4/2025 | | | |
| Coding Update | Therapeutic Drug Monitoring for Antidepressants, Antipsychotics, or Antiepileptics | 06.02.55b | | 10/1/2024 | | | 6/4/2025 | | | |
