CommercialCoverageMedium impact
08.00.55m, Omalizumab (Xolair®)
Independence Blue Cross·Allergy & Immunology, Pulmonology, Dermatology·Pharmacy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
Policy 08.00.55m for Omalizumab (Xolair®) has been updated under commercial plans effective October 1, 2025. This pharmacy policy change may affect coverage criteria, prior authorization requirements, or billing procedures for this specialty medication used primarily for asthma and chronic urticaria treatment.
Action Required
By October 1, 2025: Billing team should review the updated Omalizumab (Xolair®) policy at the provided URL to identify specific changes to coverage criteria, prior authorization requirements, or billing procedures. Update billing system rules and notify providers of any new requirements for prescribing or administering this medication.