Medicare AdvantageCoverageLow impact
MA08.033d, Agalsidase beta (Fabrazyme) and pegunigalsidase alfa-iwxj (Elfabrio)
Independence Blue Cross·Endocrinology, Nephrology, Cardiology +1 more·Medical Policy
Effective date
May 28, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.033d covering Agalsidase beta (Fabrazyme) and pegunigalsidase alfa-iwxj (Elfabrio) has been reissued and will become effective May 28, 2025. This policy affects coverage and billing for these rare disease medications used to treat Fabry disease.
Action Required
By May 28, 2025: Billing team should review the full policy document at the provided URL to understand any changes to coverage criteria, prior authorization requirements, or billing guidelines for Agalsidase beta (Fabrazyme) and pegunigalsidase alfa-iwxj (Elfabrio). Update any relevant billing protocols based on the complete policy details.