Who is affected by this change?

This affects Independence Blue Cross Endocrinology, Ophthalmology providers on Medicare Advantage plans.

When does this change take effect?

This change is effective Jul 9, 2025.

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Medicare AdvantageCoverageMedium impact

MA08.115b, Teprotumumab (Tepezza®)

Independence Blue Cross·Endocrinology, Ophthalmology·Pharmacy

Effective date

Jul 9, 2025

We identified it

Jun 19, 2026

Days to comply

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Summary

A Medicare Advantage policy for Teprotumumab (Tepezza®) has been reissued with an effective date of July 9, 2025. This is a pharmacy policy update that may affect coverage or prior authorization requirements for this thyroid eye disease medication.

Action Required

Action needed

By July 9, 2025: Billing team must review the updated MA08.115b policy for Teprotumumab (Tepezza®) at the provided URL to identify specific changes to coverage criteria, prior authorization requirements, or billing procedures. Update billing system and provider workflows accordingly for Medicare Advantage patients requiring this medication.

Related policy hubs

Independence Blue Cross policies Endocrinology Ophthalmology