Who is affected by this change?

This affects Independence Blue Cross Oncology, Hematology providers on Medicare Advantage plans.

When does this change take effect?

This change is effective Jul 1, 2025.

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Medicare AdvantageCoverageMedium impact

MA08.182a, Zanidatamab-hrii (Ziihera®)

Independence Blue Cross·Oncology, Hematology·Pharmacy

Effective date

Jul 1, 2025

We identified it

Jun 19, 2026

Days to comply

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Summary

Medicare Advantage has updated its policy for Zanidatamab-hrii (Ziihera®), a new oncology medication. This pharmacy policy change affects coverage and billing requirements for this specific drug therapy used in cancer treatment.

Action Required

Action needed

By July 1, 2025: Billing team must review the complete MA08.182a policy at the source URL to understand specific coverage criteria, prior authorization requirements, and billing procedures for Zanidatamab-hrii (Ziihera®). Update pharmacy billing protocols and ensure providers are aware of any coverage restrictions for this oncology medication.

Related policy hubs

Independence Blue Cross policies Oncology Hematology