Medicare AdvantageCoverageMedium impact
MA08.060g, Pegloticase (Krystexxa®)
Independence Blue Cross·Rheumatology, Internal Medicine, Family Medicine·Pharmacy
Effective date
Apr 30, 2025
We identified it
Jun 19, 2026
Summary
The Medicare Advantage policy for Pegloticase (Krystexxa®) has been reissued with updates, though specific changes are not detailed in the summary. This medication is used for treatment-refractory chronic gout and may affect billing and coverage requirements.
Action Required
By April 30, 2025: Billing team should review the full policy MA08.060g for Pegloticase (Krystexxa®) at the source URL to understand specific changes to coverage, prior authorization, or billing requirements. Update billing procedures and provider notifications as needed based on the detailed policy content.