Medicare AdvantageCoverageMedium impact
MA08.073r, Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists, VEGF Biosimilars, and Combination VEGF/Angiopoietin-2 (Ang-2) Inhibitors
Independence Blue Cross·Ophthalmology·Pharmacy
Effective date
Apr 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.073r has been updated regarding intravitreal injection of VEGF antagonists, VEGF biosimilars, and combination VEGF/Angiopoietin-2 inhibitors. This policy affects coverage and billing requirements for eye injections used to treat conditions like macular degeneration and diabetic retinopathy.
Action Required
By April 1, 2025: Billing team and ophthalmology providers must review updated Medicare Advantage policy MA08.073r for intravitreal VEGF injections. Verify current prior authorization requirements, coverage criteria, and documentation standards for VEGF antagonists and biosimilars. Update billing procedures and encounter forms accordingly to ensure compliance with new policy requirements.