| Policy Name |
Updated Criteria |
| CAR-T Therapy |
Added the following codes as other related CPT codes: 0870, 0871, 0872, 0873, 0874, and 0875. Added ALL indication for Tecartus |
| Place of Service |
Added the following drugs and HCPCS codes for clarity, with criteria also available in individual policies: Nexviazyme (C9085, J3490, J3590), Saphnelo (C9086, J3490, J3590), Tezspire (C9399, J3490, J3590), Enjaymo (C9399** J3490**, J3590**), and Leqvio (C9399, J3490, J3590). Updated HCPCS code for Evkeeza to J1305. |
| Efgartigimod Alfa-fcab (Vyvgart™) |
New Policy for New to Market Drug Original medical policy criteria issued |
| Inclisiran (Leqvio®) |
New Policy for New to Market Drug Original medical policy criteria issued. |
| Ocular Angiogenesis Inhibitor Agents |
New to market drug addition to existing policy |
| Sutimlimab (Enjaymo™) Enjaymo |
New Policy for New to Market Drug Original medical policy criteria issued. |
| Tezepelumab-ekko (Tezspire™) |
New Policy for New to Market Drug Original medical policy criteria issued. |
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