Blue Shield of California policy updates
Track new and updated Blue Shield of California policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Degarelix (Firmagon) Coverage | Blue Shield Of California | Clinical | Pharmacy & Specialty Drugs | Modified | Apr 1, 2026 |
| Endobronchial Ultrasound for Diagnosis and Staging of Lung Cancer | Blue Shield Of California | Clinical | Radiology/Diagnostic Imaging | Modified | Nov 1, 2025 |
| UM Referral to Complex Case Management | Blue Shield Of California | Administrative | — | Modified | — |
| Minimally Invasive Ablation Procedures for Morton and Other Peripheral Neuromas | Blue Shield Of California | Clinical | Podiatry | Modified | — |
| Saturation Biopsy for Diagnosis, Staging, and Management of Prostate Cancer | Blue Shield Of California | Clinical | Urology | Modified | — |
| Agalsidase beta (Fabrazyme) | Blue Shield Of California | Clinical | Pharmacy & Specialty Drugs | Modified | — |
| Avacincaptad pegol (Izervay) | Blue Shield Of California | Clinical | Pharmacy & Specialty Drugs | Modified | — |
| epoetin alfa | Blue Shield Of California | Clinical | Pharmacy & Specialty Drugs | Modified | — |
| Hematopoietic Cell Transplantation for Miscellaneous Solid Tumors in Adults | Blue Shield Of California | Clinical | Transplant | Modified | — |
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.