Medicare Advantage Part B Drug Updates 12012025
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 Part B Utilization Management in the Absence of NCD or LCD
Effective Date: 12/01/2025
Preauthorization Required: Yes
Policy Statement:
Adding to the policy to require prior authorization:
- J7504 (Atgam- Lymphocyte Immune Globulin)
- A9530 (Iodine i-131 Sodium Iodide solution)
- J7336 (Qutenza)
We contract with Prime Therapeutics for Part B drugs/medications. Please submit PA requests directly to GatewayPA.
- Hours of Operation: 24 hours a day
- Call toll free: 1-800-424-1709 or fax 1-888-656-6671
- Website: https://gatewaypa.com/