CommercialCoverageMedium impact
Material Amendment and Policy Criteria Changes
Arkansas Blue Cross Blue Shield·AR · Radiation Oncology, Dermatology, Oncology +1 more·Medical Policy
Effective date
Nov 1, 2025
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross updated four policies: Donanemab coverage criteria now requires MMSE scores 20-30 (expanded from 20-28) and excludes patients with certain brain hemorrhages; Digital Breast Tomosynthesis and Brexanolone policies will be archived; Low-Dose Radiotherapy is now covered for nonmelanoma skin cancers when specific criteria are met.
Action Required
By November 1, 2025: Update billing system to reflect new LDRT coverage for nonmelanoma skin cancers using CPT 77401 only (not other radiation codes). Add prior authorization requirements for Donanemab with updated MMSE score range 20-30 and hemorrhage exclusions. Prepare for archival of Digital Breast Tomosynthesis and Brexanolone policies. Training required for radiation oncology and dermatology staff on new LDRT criteria and coding guidelines.