Medicare AdvantageCoverageMedium impact
MA08.093p, Chimeric Antigen Receptor (CAR) Therapy
Independence Blue Cross·Oncology, Hematology·Medical Policy
Effective date
Feb 24, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage has updated medical necessity criteria for Chimeric Antigen Receptor (CAR) therapy, effective February 24, 2025. This policy change affects the requirements for determining when CAR-T cell therapy is considered medically necessary for coverage.
Action Required
Immediately: Review updated medical necessity criteria for CAR therapy claims. Oncology and hematology providers must ensure documentation meets new Medicare Advantage requirements before submitting claims. Billing team should verify current criteria in system at https://medpolicy.ibx.com for specific documentation requirements to avoid claim denials.