Immunology/Rheumatology policy updates
Track new and updated Immunology/Rheumatology policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Intravenous Immune Globulin (IVIG) | Blue Cross Blue Shield - Tennessee | Clinical | Immunology/Rheumatology | Modified | Jun 30, 2026 |
| Rituximab Products (Rituxan®, Truxima®, Riabni™, Ruxience®) — Non‑Oncology Indications | Blue Cross Blue Shield - Tennessee | Clinical | Immunology/Rheumatology | Modified | Jun 30, 2026 |
| Inebilizumab-cdon (Uplizna) — Coverage Criteria for IgG4‑RD, NMOSD (AQP4+), and gMG (antibody‑positive) | Blue Cross Blue Shield - Tennessee | Clinical | Immunology/Rheumatology | Modified | Jun 30, 2025 |
| Immunopharmacologic Monitoring of Therapeutic Serum Antibodies | Blue Cross Blue Shield - Tennessee | Clinical | Immunology/Rheumatology | Modified | Jul 1, 2023 |
| ANA/ENA Testing | Blue Cross Blue Shield - Tennessee | Clinical | Immunology/Rheumatology | Modified | Jul 1, 2023 |
| Immune Cell Function Assay | Blue Cross Blue Shield - Tennessee | Clinical | Immunology/Rheumatology | Modified | Jul 1, 2023 |
| Immunopharmacologic Monitoring of Therapeutic Serum Antibodies | Blue Cross Blue Shield - Tennessee | Clinical | Immunology/Rheumatology | Modified | — |
| Immunopharmacologic Monitoring of Therapeutic Serum Antibodies | Blue Cross Blue Shield - Tennessee | Clinical | Immunology/Rheumatology | Modified | — |
| Immunopharmacologic Monitoring of Therapeutic Serum Antibodies (Therapeutic Drug Monitoring for Biologic Therapies) | Blue Cross Blue Shield - Tennessee | Clinical | Immunology/Rheumatology | Modified | — |
| Belimumab (Benlysta) — Coverage Criteria for Systemic Lupus Erythematosus and Lupus Nephritis | Blue Cross Blue Shield - Tennessee | Clinical | Immunology/Rheumatology | 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.
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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.