Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Recorded changes
82,244 on record
Recorded policy changes, newest first| Recorded | Payer | Policy | Change |
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| Aug 22, 2026 | Independence Blue Cross | Agalsidase beta (Fabrazyme) and pegunigalsidase alfa-iwxj (Elfabrio)PayerPolicy · IBX-COMMERCIAL-08-00-69 | Codes changed |
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| Aug 22, 2026 | Independence Blue Cross | Afamitresgene autoleucel (Tecelra)PayerPolicy · IBX-COMMERCIAL-08-02-32 | Codes changed |
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| Aug 22, 2026 | Independence Blue Cross | Ado-Trastuzumab Emtansine (Kadcyla)PayerPolicy · IBX-COMMERCIAL-08-01-11 | Codes changed |
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| Aug 22, 2026 | Independence Blue Cross | ADAMTS13, recombinant-krhn (Adzynma)PayerPolicy · IBX-COMMERCIAL-08-02-21 | Codes changed |
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| Aug 22, 2026 | Independence Blue Cross | Abatacept (Orencia) for Injection for Intravenous UsePayerPolicy · IBX-COMMERCIAL-08-00-62 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Pompe Disease Treatment with Lumizyme (Alglucosidase alfa)PayerPolicy · BCBSNJ-DRUGS-044-434BE64CB4 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Granulocyte Colony Stimulating Factor (G-CSF - Neupogen, Neulasta, Granix, Zarxio, Fulphila, Nivestym, Udenyca, Ziextenzo, Nyvepria) and Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF - Leukine)PayerPolicy · BCBSNJ-DRUGS-012-E7C32F18C6 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Trastuzumab (Herceptin), Trastuzumab-dkst (Ogivri), Ado-trastuzumab emtansine (Kadcyla), Trastuzumab-pkrb (Herzuma), Trastuzumab-dttb (Ontruzant), Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta), Trastuzumab-qyyp (Trazimera), Trastuzumab-anns (Kanjinti), Fam-trastuzumab deruxtecan-nxki (Enhertu), Pertuzumab (Perjeta), and Pertuzumab, Trastuzumab, and hyaluronidase-zzxf (Phesgo)PayerPolicy · BCBSNJ-DRUGS-011-749DD9CCDF | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Topotecan Hydrochloride (Hycamtin) InjectionPayerPolicy · BCBSNJ-DRUGS-020-CF390C2BC8 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Progesterone Therapy as a Technique to Reduce Preterm Delivery in High Risk PregnanciesPayerPolicy · BCBSNJ-OBSTETRICS-006-F86C46D1F6 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Omalizumab (Xolair)PayerPolicy · BCBSNJ-DRUGS-025-2F12D9BC7F | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Agalsidase Beta (Fabrazyme)PayerPolicy · BCBSNJ-DRUGS-028-8EA56EDE5B | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Laronidase (Aldurazyme), Galsulfase (Naglazyme), and Idursulfase (Elaprase), Elosulfase alfa (Vimizim), and Vestronidase alfa (Mepsevii)PayerPolicy · BCBSNJ-DRUGS-027-1770B890D6 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Infliximab (Remicade), infliximab-dyyb (Inflectra), and infliximab-abda (Renflexis), infliximab-qbtx (Ixifi), and infliximab-axxq (Avsola)PayerPolicy · BCBSNJ-DRUGS-017-43C6A62377 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Alpha 1-Proteinase Inhibitors (Human) [Prolastin-C, Aralast NP, Zemaira, Glassia]PayerPolicy · BCBSNJ-DRUGS-014-45021456CA | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Rituximab (Rituxan), Rituximab-abbs (Truxima), Rituximab-pvvr (Ruxience), and Rituximab/hyaluronidase (Rituxan Hycela)PayerPolicy · BCBSNJ-DRUGS-043-F492DC55BC | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Abatacept (Orencia)PayerPolicy · BCBSNJ-DRUGS-042-032BB0E04E | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Clolar (Clofarabine)PayerPolicy · BCBSNJ-DRUGS-037-91C3D866D2 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Brexucabtagene autoleucel (Tecartus)PayerPolicy · BCBSNJ-DRUGS-211-557AFD47DA | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Inebilizumab-cdon (Uplizna)PayerPolicy · BCBSNJ-DRUGS-210-F1ADA34CD4 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Lurbinectedin (Zepzelca)PayerPolicy · BCBSNJ-DRUGS-209-A031877732 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Bimatoprost Implant (Durysta)PayerPolicy · BCBSNJ-DRUGS-207-AE32BF0E1A | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Mitomycin for Pyelocalyceal Solution (Jelmyto)PayerPolicy · BCBSNJ-DRUGS-206-E9A4AEB6C4 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Sacituzumab govitecan-hziy (Trodelvy)PayerPolicy · BCBSNJ-DRUGS-205-8E1FC60470 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Eptinezumab-jjmr (Vyepti)PayerPolicy · BCBSNJ-DRUGS-203-5C937D381C | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Isatuximab-irfc (Sarclisa)PayerPolicy · BCBSNJ-DRUGS-202-47A6C423B3 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Teprotumumab-trbw (Tepezza)PayerPolicy · BCBSNJ-DRUGS-201-06E0D41640 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Enfortumab vedotin-ejfv (Padcev)PayerPolicy · BCBSNJ-DRUGS-200-52E5735908 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Givosiran (Givlaari)PayerPolicy · BCBSNJ-DRUGS-199-9AB4C22BE2 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Crizanlizumab-tmca (Adakveo)PayerPolicy · BCBSNJ-DRUGS-198-09BF92D8E7 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Gemcitabine in sodium chloride injection (Infugem)PayerPolicy · BCBSNJ-DRUGS-197-9A2A0DDA05 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Luspatercept-aamt (Reblozyl)PayerPolicy · BCBSNJ-DRUGS-196-CF98A8E728 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Polatuzumab vedotin-piiq (Polivy)PayerPolicy · BCBSNJ-DRUGS-195-F942AC98E5 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Romosozumab-aqqg (Evenity)PayerPolicy · BCBSNJ-DRUGS-194-A870D79393 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Tagraxofusp-erzs (Elzonris)PayerPolicy · BCBSNJ-DRUGS-188-DAE70C3139 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Triamcinolone Acetonide Extended-Release (Zilretta)PayerPolicy · BCBSNJ-DRUGS-181-B68D7DC6B6 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Ibalizumab-uiyk (Trogarzo)PayerPolicy · BCBSNJ-DRUGS-178-1D21FCB9E6 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Hemophilia Products – von Willebrand Factor (von Willebrand Disease): VonvendiPayerPolicy · BCBSNJ-DRUGS-175-2475EE9819 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Hemophilia Products - Factor VIII (Hemophilia A) and Factor IX (Hemophilia B) with inhibitors, Acquired Hemophilia, Congenital Factor VII Deficiency, and Glanzmann’s Thrombasthenia: Novoseven RT and SevenfactPayerPolicy · BCBSNJ-DRUGS-174-9E4E74480C | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Hemophilia Products - Congenital Factor XIII Deficiency: CorifactPayerPolicy · BCBSNJ-DRUGS-173-4660DA8B78 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Hemophilia Products – Congenital Factor XIII A-Subunit Deficiency: TrettenPayerPolicy · BCBSNJ-DRUGS-172-FFF2466D5F | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Hemophilia Products - Factor X: CoagadexPayerPolicy · BCBSNJ-DRUGS-171-D43CFD8E5C | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Hemophilia Products - Factor VIII (Hemophilia A) and Factor IX (Hemophilia B) with Inhibitors: Feiba NFPayerPolicy · BCBSNJ-DRUGS-170-69F2945E23 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Hemophilia Products - Congenital Factor VIII (Hemophilia A) with or without inhibitors: HemlibraPayerPolicy · BCBSNJ-DRUGS-169-7E9FCDD462 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Hemophilia Products – Factor VIII (Hemophilia A, Congenital and Acquired): Advate, Adynovate, Afstyla, Eloctate, Helixate FS, Hemofil M, Koate-DVI, Kogenate FS, Kovaltry, Monoclate-P, Novoeight, NUWIQ, Recombinate, Xyntha, Obizur, Jivi and EsperoctPayerPolicy · BCBSNJ-DRUGS-168-FAD617C1CB | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Hemophilia Products - Factor VIII (Hemophilia A) and Von Willebrand disease (VWD): Alphanate, Humate-P, and WilatePayerPolicy · BCBSNJ-DRUGS-167-0AD81A4A4E | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Hemophilia Products – Factor IX (Hemophilia B): Alphanine SD, Alprolix, Bebulin, Benefix, Idelvion, Ixinity, Mononine, Profilnine, Rebinyn, and RixubisPayerPolicy · BCBSNJ-DRUGS-166-E2C66D26FF | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Yondelis (Trabectedin)PayerPolicy · BCBSNJ-DRUGS-132-2240D27BD2 | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Imlygic (Talimogene Laherparepvec)PayerPolicy · BCBSNJ-DRUGS-131-EB13DCADAD | Codes changed |
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| Aug 22, 2026 | Horizon BCBSNJ | Onivyde (Irinotecan Liposome Injection)PayerPolicy · BCBSNJ-DRUGS-130-1CF8B7240C | Codes changed |
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