Medicare Advantage Part B Drug Updates 07012025

Blue Cross and Blue Shield of Nebraska is proud to work with our provider network to serve your patients, our members. We are updating several medical policies. Please review the changes and effective dates outlined here:

Medicare Advantage M.16 MA Part B Utilization Management in the Absence of NCD or LCD

Effective Date: 07/01/2025
Preauthorization Required: Yes

Policy Statement:

Adding:  J9999 Vyloy (zolbetuximabclzb)  NDC: 0469-3425-10

Please submit PA request directly to Prime.

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