Blue Cross Blue Shield - South Carolina policy updates
Track new and updated Blue Cross Blue Shield - South Carolina policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Actimmune (interferon gamma-1b) and related specialty drug prior authorization criteria (partial) | Blue Cross Blue Shield - South Carolina | Clinical | Immunology/Rheumatology | Modified | Aug 1, 2026 |
| Actimmune (interferon gamma-1b) — Prior Authorization and Coverage Criteria | Blue Cross Blue Shield - South Carolina | Clinical | Immunology/Rheumatology | Modified | Aug 1, 2026 |
| Drug coverage criteria for specialty and outpatient medications | Blue Cross Blue Shield - South Carolina | Clinical | Immunology/Rheumatology | Modified | Jun 1, 2026 |
| Drug benefit coverage: specialty medications — coverage criteria | Blue Cross Blue Shield - South Carolina | Clinical | Immunology/Rheumatology | Modified | Jun 1, 2026 |
| 2026 Pdp Pa Criteria | Blue Cross Blue Shield - South Carolina | Clinical | Pharmacy & Specialty Drugs | Modified | Jun 1, 2026 |
| Formulary step therapy and prior authorization criteria for selected psychiatric and related drugs | Blue Cross Blue Shield - South Carolina | Clinical | Psychiatry/Behavioral Health | Modified | Jun 1, 2026 |
| Drug-specific medical necessity and prior authorization criteria (partial list) | Blue Cross Blue Shield - South Carolina | Clinical | Immunology/Rheumatology | Modified | May 1, 2026 |
| Drug-specific prior authorization criteria for specialty medications | Blue Cross Blue Shield - South Carolina | Clinical | Immunology/Rheumatology | Modified | May 1, 2026 |
| Drug coverage and step therapy rules (partial index) | Blue Cross Blue Shield - South Carolina | Clinical | Pharmacy & Specialty Drugs | Modified | May 1, 2026 |
| BlueCross Total Prescription Drug Formulary — Coverage Criteria | Blue Cross Blue Shield - South Carolina | Clinical | Pharmacy & Specialty Drugs | Modified | May 1, 2026 |
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.
OpenPayer by Trek Health — Policy intelligence for billing and revenue cycle teams.
Coverage data is sourced from publicly available payer medical policy documents and updated as payers publish revisions. Read more about where our data comes from. Always consult the primary payer source for clinical decision-making.