Carvykti to require prior authorization for Medicare Advantage members starting March 7

For dates of service on or after March 7, 2022, Carvykti (ciltacabtagene autoleucel), HCPCS code J9999, will require prior authorization for Medicare Plus BlueSM and BCN Advantage members.

Submit prior authorization requests using the NovoLogix® online tool.

When prior authorization is required

We require prior authorization for this drug for all sites of care in which it is administered.

Submitting prior authorization requests

Submit prior authorization requests for these drugs using the NovoLogix online tool. It offers real-time status checks and immediate approvals for certain medications.

If you have access to Provider Secured Services, you already have access to NovoLogix.

If you need to request access to Provider Secured Services, complete the Provider Secured Access Application (PDF) form and fax it to the number on the form.

List of requirements

For a list of requirements related to drugs covered under the medical benefit, please see the Medical Drug and Step Therapy Prior Authorization List for Medicare Plus Blue PPO and BCN Advantage members.

We'll update the list to reflect these changes prior to the effective date.

Posted: March 2022
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network