Pharmacotherapy of Inflammatory Bowel Disorder
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Medical and pharmacy coverage and site-of-service, prior authorization, and step-therapy rules for pharmacologic treatment of inflammatory bowel disorders (primarily Crohn's disease and ulcerative colitis) for Premera Blue Cross members.
No material clinical or coverage changes in this revision.
Coverage Criteria
Site of Service — medically necessary criteria
Covered when specific site-of-service clinical conditions are met
Preferred medically necessary sites for IV infusion and injection therapy; hospital-based outpatient setting considered medically necessary for the first 90 days for initial/re‑initiation therapy or when clinical risk factors present
Also medically necessary for grade 3–4 cytokine release syndrome meeting physiologic criteria and when inpatient admission is planned
Initial/First-line therapy groupings
Agents grouped as first-line inhibitors with formulation and sequencing notes
Some SC formulations are specified 'use after IV only' or listed as IV induction in tier notes
Step therapy coverage criteria
Covered when following the policy's step therapy tier sequencing and route requirements
Many agents appear in multiple tiers; follow the specific tier mapping in the Policy section
Examples in the document: Stelara IV (induction) vs Stelara SC (use after IV only)
NDC documentation is requested where noted in the policy fragments
Step therapy and route prerequisites
Covered when following route- and tier-specific prerequisites are met
Supported across document fragments listing induction and 'use after IV only' annotations
Multiple chunks enumerate these IV induction options
Several SC agents are annotated 'use after IV only' in the fragments
Referenced in tier listings
Step therapy tier criteria
Agents are assigned to numbered step therapy tiers (1–7). Some agents require IV induction prior to SC use; coverage follows the tier sequence.
See the Policy section for the full tier mappings shown in the document fragments
Step Therapy Tier Listings
Step therapy tiers (numbered 1–7) set preferred sequencing; some agents are induction (IV) only and some SC formulations are to be used only after IV induction.
Agents repeated across chunks include adalimumab biosimilars (aaty, adaz, adbm), Stelara, Steqeyma, Yesintek, Omvoh, Skyrizi, Tremfya, Inflectra; many IV entries are marked 'induction'
Crohn's Disease - Second Line
Crohn's Disease - Second Line tier listings use similar numbering and induction designations.
Fragment does not include explicit patient‑level failure criteria in this window; refer to the full Policy section
Crohn's Disease - Second Line therapy tiers
Covered when following the listed step therapy sequencing for Crohn's Disease second-line therapy
Preserve IV then SC sequencing as indicated
Crohn's Disease - Second Line step therapy
Crohn's Disease - Second Line: covered when therapy follows the policy's step therapy sequencing
Document fragments repeat lists across tiers; specific tier‑by‑tier distinctions are not separable in this excerpt
Second Line step therapy (Crohn's Disease)
Step therapy coverage applies to Second Line therapy for Crohn's disease and is organized by inhibitor class and route:
Exact step sequencing and any required prior failures are in the main Policy section (not included in this window)
Step therapy agent listing (no full criteria in extracted fragments)
Step therapy tiers and agent routing for Crohn's Disease - Second Line
Exact step order and any required prior agent trials are not contained within these chunks; refer to the Policy section for full logic
Step therapy agent lists and sequencing
Covered when used in the step therapy sequence described below for Crohn's disease second-line therapy
Sequencing implies IV induction availability for certain agents and restriction of some SC products to post‑IV use
Crohn's Disease — Second-line biologic step therapy
Second-line Crohn's disease — step therapy tiers (induction vs maintenance and agent groups)
Policy fragments repeat the same tier groupings across multiple numbered entries
Step therapy structure — induction (IV) then SC maintenance
Covered when consistent with step therapy tiers and induction/maintenance routing
Tiers enumerated 1 through 7 across the document fragments
Hospital-based outpatient infusion is covered only when site-of-service clinical criteria are met. Preferred medically necessary sites include physician’s office, infusion center, and home infusion. The hospital-based outpatient setting (outpatient hospital IV infusion department) is considered medically necessary for the first 90 days of an initial infusion or re‑initiation after ≥6 months, or when the member has specified clinical risk factors that increase the risk of infusion complications (for example: symptomatic cardiac arrhythmia, significant respiratory disease with %FVC ≤40%, unstable renal function, difficult/unstable vascular access, acute cognitive/mental status changes affecting safety, or prior severe adverse drug reaction/anaphylaxis).
The policy lists first‑line step therapy groupings by drug class and formulation. Examples include TNF‑α inhibitors (IV agents such as Avsola and Inflectra and SC adalimumab biosimilars), IL‑12/23 agents (Stelara IV induction with Stelara SC noted as use after IV only), IL‑23 inhibitors (Skyrizi and Tremfya with IV induction options), the integrin inhibitor Entyvio (IV), and the oral agent Rinvoq. Several SC products are explicitly annotated as maintenance formulations that require prior IV induction.
Coverage of a requested biologic or targeted therapy is conditioned on adherence to the policy’s step‑therapy tiers and route requirements. The requested product must align with the numbered tier sequence (tiers 1–7) shown in the policy, and when an agent is annotated as IV (induction) the IV induction formulation is expected for initial therapy. For products identified by specific product codes, such as adalimumab‑adbm, include the NDC prefix 00597 when requested to identify the exact product variant.
Many step‑therapy entries distinguish induction (IV) formulations from SC maintenance formulations and require sequencing accordingly. SC agents labelled ‘use after IV only’ are covered only after an appropriate IV induction course (examples of IV induction options listed include Stelara IV, Steqeyma IV, Yesintek IV, Omvoh IV, Skyrizi IV, Tremfya IV, Entyvio IV, Avsola IV, and Inflectra IV). SC maintenance options include adalimumab biosimilars and SC formulations of Stelara, Steqeyma, Yesintek, Omvoh, Skyrizi, and Tremfya when the induction requirement has been met.
Agents are assigned across numbered step‑therapy tiers (1 through 7) and coverage/authorization requests should follow the tier ordering in the policy. Several agents are specifically identified as induction (IV) formulations and corresponding SC formulations are denoted as maintenance or use after IV only; failure to follow the tier ordering and route sequencing may affect prior authorization decisions.
The policy repeatedly enumerates tiered lists of biologic and biosimilar agents across the seven step‑therapy tiers. Many entries reiterate that some products are intended for IV induction while matching SC formulations are indicated for maintenance or are restricted to use after IV only. Providers should reference the full policy tier lists when determining the preferred sequencing for a given request.
A discrete section labeled Crohn’s Disease — Second Line mirrors the general step‑therapy structure: IV induction agents and SC maintenance agents are assigned to numbered second‑line tiers (1–7). The fragmentary listings repeat the same agents and route annotations used elsewhere in the policy; consult the full Policy section for specific tier‑by‑tier ordering and any patient‑level prerequisites.
Coverage for Crohn’s disease second‑line therapy follows the listed step‑therapy sequencing. The document lists IV induction options (for example, Steqeyma IV, Yesintek IV, Skyrizi IV, Tremfya IV) and SC maintenance choices (including multiple adalimumab biosimilars and SC formulations of Stelara, Steqeyma, Yesintek, Omvoh, Skyrizi, Tremfya), with several SC agents annotated as use after IV only and therefore not eligible as initial SC therapy without prior IV induction.
The Crohn’s Disease second‑line listings are presented repeatedly across tier numbers and emphasize class‑level groupings (TNF‑α inhibitors, IL‑12/23 inhibitors, α4‑integrin inhibitors) with explicit route distinctions. Multiple SC products are annotated as maintenance and flagged use after IV only; adalimumab biosimilars (including adalimumab‑adbm identified by NDCs starting with 00597) are repeatedly listed as SC options.
Second‑line step therapy for Crohn’s disease is organized by inhibitor class and administration route. IV induction agents (e.g., Steqeyma IV, Yesintek IV, Skyrizi IV, Tremfya IV) and SC maintenance agents (adalimumab biosimilars and several branded SC products) are enumerated; when SC agents are annotated use after IV only, coverage is contingent on documented prior IV induction per the policy.
The document contains repeated enumerations of Crohn’s Disease second‑line tier agents and their routing, including TNF‑α inhibitors (adalimumab biosimilars such as adalimumab‑aaty, adalimumab‑adaz, adalimumab‑adbm), IL‑12/23 inhibitors (Stelara, Steqeyma), and α4‑integrin inhibitors (Yesintek and others). Many entries reiterate IV induction designations and list SC forms as maintenance or use after IV only.
Step‑therapy agent lists repeat across the policy window: induction‑designated IV agents are listed alongside SC maintenance options. Specific agents named include Yesintek and Tremfya (IV induction and SC maintenance), multiple adalimumab biosimilars (including adalimumab‑adbm with NDCs starting with 00597), Stelara (SC restricted to use after IV only), Steqeyma, Omvoh, Skyrizi, and Tremfya in SC presentations.
Second‑line Crohn’s disease tiers emphasize induction versus maintenance: where indicated, IV induction is required before SC maintenance. The repeated lists show TNF‑α inhibitors (adalimumab biosimilars), IL‑12/23 inhibitors (Stelara, Steqeyma), and other biologics (Yesintek, Tremfya, Skyrizi, Omvoh) with the same route and sequencing annotations; several SC formulations are clearly designated use after IV only.
The policy’s structural principle for step therapy is IV induction followed by SC maintenance where specified. Induction agents (for example, Yesintek IV or Tremfya IV) are listed as initial options; multiple SC agents (including adalimumab biosimilars, Stelara SC, Skyrizi SC, Tremfya SC) are listed as maintenance and several are annotated as use after IV only, meaning SC initiation without prior IV induction is inconsistent with the sequencing in these excerpts.
When the clinical criteria for hospital‑based outpatient infusion are not met, that site is considered not medically necessary for infusion or injectable therapy. The policy does not govern inpatient IV/injectable therapy services; inpatient administration is addressed separately and is not within this outpatient site‑of‑service rule set.
There are no new explicit exclusions listed in this fragmentary window; however, route‑specific sequencing restrictions function as de facto exclusions—for example, SC formulations annotated use after IV only are not eligible as initial therapy until required IV induction has occurred.
SC maintenance formulations that the policy explicitly labels ‘use after IV only’ are not appropriate for first‑line therapy without documented prior IV induction and therefore would be considered inconsistent with the step‑therapy sequencing in this policy.
This excerpt does not add other explicit exclusions beyond the route‑sequencing notes; the main policy contains the detailed tier and agent lists that govern coverage decisions.
Within the presented fragments there are no additional explicit exclusion statements; the step‑therapy lists and route annotations are the operative coverage constraints in this window.
No further explicit exclusions are present in this fragment; coverage determinations rely on adherence to the step‑therapy tiers and route‑specific requirements.
The document window does not specify additional exclusions for patient populations or diagnoses; the policy’s exclusions section in the full document should be consulted for comprehensive exclusion rules.
No explicit exclusions are listed in the Crohn’s Disease second‑line fragments shown here beyond sequencing restrictions that limit SC‑only initiation when an IV induction is required.
These fragments do not contain separate patient‑level exclusion criteria; step‑therapy sequencing (including IV induction prerequisites) are the primary constraints described in this section.
The policy excerpts here do not introduce additional explicit exclusions; they reiterate tiered agent lists and route‑specific sequencing that guide coverage decisions.
No explicit not‑medically‑necessary statements are provided in these chunks; however, use of an SC formulation that is labeled use after IV only as initial therapy would be considered inconsistent with the step‑therapy sequencing and may be deemed not medically necessary.
The policy fragments shown do not identify discrete patient population exclusions or diagnosis‑code exclusions within this window; coverage constraints are primarily articulated as step‑therapy sequencing and site‑of‑service criteria.
Coding and Identifiers
| 00597 | NDC prefix referenced for adalimumab-adbm |
| NDCs starting with 00597 | Adalimumab-adbm product NDC prefix |
| NDCs starting with 00597 | adalimumab-adbm NDC prefix noted in policy |
| NDCs starting with 00597 | Adalimumab-adbm product NDC prefix noted |
| NDCs starting with 00597 | Adalimumab-adbm NDCs (as noted) |
| NDCs starting with 00597 | adalimumab-adbm (SC) specific NDC prefix |
| NDCs starting with 00597 | Adalimumab-adbm NDC prefix noted in policy |
| NDC prefix 00597 | Adalimumab-adbm NDCs starting with 00597 |
| NDCs starting with 00597 | Adalimumab-adbm NDC prefix as noted in document |
| NDCs starting with 00597 | Adalimumab-adbm identification by NDC prefix as listed in policy |
| NDCs starting with 00597 | Adalimumab-adbm NDC prefix noted in policy |
| NDCs starting with 00597 | Adalimumab-adbm product identification by NDC prefix |
Provider Actions and Prior Authorization
Medical necessity review and site-of-service
Specific intravenous and injectable drugs listed in this policy will be reviewed for medical necessity and site-of-service; for members age 13 and older the site of service will be reviewed. Site-of-service medical necessity applies to medical benefit reviews and failure to meet site-of-service or medical benefit review criteria may result in denial.
Step therapy tiers require prior authorization
Step therapy tiers are defined in the policy and providers must refer to the Policy section for details when requesting authorization for tiered agents.
Step therapy tiers require PA per policy section
The presence of step therapy tiers in the policy implies prior authorization is required; providers must consult the Policy section for explicit PA submission details.
Prior authorization requires step therapy tier compliance
Prior authorization determinations must show compliance with the policy's step therapy tiers (1–7) and any route/induction specifications (e.g., IV induction before SC 'use after IV only').
Prior authorization required for biologics and targeted therapies
Prior authorization is required for listed biologic and targeted therapies; include product identifiers where specified (for example, adalimumab-adbm NDCs starting with 00597) and document prior use of listed step agents.
Step-therapy prior authorization required
Requests for agents assigned to step-therapy tiers must follow the policy's step-therapy rules; prior authorization review is governed by these tier assignments and sequencing.
Step-therapy prior authorization required
Prior authorization is organized around the policy's step-therapy tiers for multiple SC and IV biologic/biosimilar products; some adalimumab biosimilar NDCs are explicitly identified (NDCs starting with 00597).
Prior authorization required
Prior authorization is implied for agents listed in the Crohn's Disease — Second Line step therapy tiers; providers should reference the policy tier lists when requesting coverage.
Prior authorization - step therapy
Prior authorization for Crohn's Disease second-line biologics is directed by the step therapy tiers; providers must reference the listed sequence (IV induction and SC maintenance where noted) when submitting PA requests.
Prior authorization influenced by step therapy
Prior authorization decisions will be influenced by the policy's step therapy tiers; when SC formulations are labeled 'use after IV only', documentation of prior IV induction is expected.
Step therapy tiers — follow policy ordering
Providers must follow the policy's step-therapy ordering when requesting coverage for listed biologic agents; tiered lists in the policy show the required sequencing.
Step therapy applies to listed agents
Agents listed in the policy (both IV induction and SC maintenance forms) are subject to the step therapy sequencing described; prior authorization will follow that sequencing for coverage.
Prior authorization / step therapy applies
Prior authorization and step-therapy review apply to second-line biologic agents for Crohn's disease; note many SC products are listed as 'use after IV only' and require prior IV induction per the tiers.
Step-therapy prior authorization guidance
Prior authorization for Crohn's second-line biologics is guided by step-therapy tiers that list IV induction agents (e.g., Yesintek IV, Tremfya IV) and SC agents (many flagged 'use after IV only'); follow these tiered preferences when submitting PAs.
Prior authorization required per step therapy tiers
The policy defines numbered step therapy tiers for second-line biologic therapy in Crohn's disease and distinguishes IV induction agents from SC maintenance agents; prior authorization is expected for agents subject to step edits.
Step therapy requirement
Providers must follow the policy's step-therapy sequencing for Crohn's disease (multiple first-line tiers by drug class and specific agents listed) when requesting coverage.
Step therapy tiers and agent groupings
Multiple repeated policy lists define first-line and second-line step therapy tiers across TNF-α, IL-12/23, IL-23, α4-integrin, and JAK classes; providers must request treatments in accordance with these tier groupings and route designations.
Enumerated step therapy tiers (1–7)
The policy enumerates step therapy tiers numbered 1 through 7 listing preferred IV induction and SC maintenance agents (examples include Inflectra/Avsola IV, Stelara IV induction and Stelara SC 'use after IV only', adalimumab biosimilars SC, Yesintek IV/SC, Skyrizi IV/SC, Tremfya IV/SC).
Follow tiers and route/induction sequencing
Providers must follow the defined step therapy tiers (1–7) and the route/induction sequencing when requesting coverage; several SC agents are specified as 'use after IV only' and require prior IV induction per policy notes.
Tier structure: IV induction then SC maintenance
Step therapy tiers group IV induction formulations and SC maintenance formulations; SC products annotated 'use after IV only' require prior IV induction before coverage as maintenance.
Tier assignments and IV→SC sequencing
Multiple agents are organized into step therapy tiers 1–7; several agents have IV induction designations and corresponding SC maintenance forms that are limited to use after IV induction.
Tiered steps and induction sequencing
The numbered step tiers (1–7) are defined across many biologic agents; several products are designated for IV induction and some SC formulations are labeled 'use after IV only' and require documented induction.
Step therapy tiers listed
Crohn's Disease second-line step therapy tiers list IV induction agents (Steqeyma, Yesintek, Skyrizi, Tremfya) and SC maintenance agents (adalimumab biosimilars, Stelara SC, Steqeyma SC, Yesintek SC, Omvoh SC, Skyrizi SC, Tremfya SC) — follow these sequences for authorization requests.
Step therapy tiers listing
The policy repeatedly lists step therapy tiers for Crohn's second-line therapy; providers must adhere to the tier sequencing and note SC agents flagged 'use after IV only' when documenting prior therapy.
Step therapy tiers and agent groupings
Step therapy tiers list second-line agents grouped by inhibitor class and specify IV induction agents (e.g., Steqeyma IV, Yesintek IV, Skyrizi IV, Tremfya IV) with SC maintenance agents that may be restricted to 'use after IV only'.
Listed step therapy agents and routing (IV vs SC)
Crohn's Disease — Second Line listings repeat TNF-α inhibitors (adalimumab biosimilars including adalimumab-adbm with NDCs starting with 00597), IL-12/23 inhibitors (Stelara, Steqeyma), α4-integrin and others (Yesintek, Tremfya, Skyrizi, Omvoh); many SC agents noted 'use after IV only'.
Defined step therapy agent lists
The policy defines multiple step therapy agent lists and sequencing for Crohn's second-line therapy across TNF-α, IL-12/23, and integrin inhibitors; adalimumab biosimilars and multiple IV induction options are included.
Listed step therapy tiers and agent grouping
Step therapy tiers for Crohn's second-line biologics enumerate TNF-α inhibitors (adalimumab biosimilars), IL-12/23 inhibitors (Stelara, Steqeyma) and other biologics (Yesintek, Tremfya, Skyrizi, Omvoh) with IV induction and SC maintenance distinctions.
Tiered biologic sequence
The tiered biologic sequence repeats the same group of agents across numbered tiers: Yesintek (IV induction, SC use after IV), Tremfya (IV induction, SC maintenance), adalimumab biosimilars (adalimumab-aaty, -adaz, -adbm with NDC prefix 00597), Stelara (SC use after IV only), Steqeyma, Omvoh, Skyrizi.
Step therapy tiers (induction IV then SC maintenance)
Step therapy tiers for Crohn's disease are presented as induction (IV) agents followed by SC maintenance agents; follow the induction→maintenance pattern where specified in the tier lists.
Claims processing
Claims for drugs administered via an intravenous route must be processed through the medical benefit (not pharmacy).
Medication identification (NDC)
The policy references NDC prefixes for adalimumab-adbm (notably NDCs starting with 00597); include medication-level identification (NDC) when submitting prior authorization for adalimumab-adbm.
NDC documentation for adalimumab-adbm
When submitting authorization for adalimumab-adbm include NDC information to identify the specific product (NDCs starting with 00597) as cited in the policy.
Support for route-specific step requirements
Documentation must support prior use or failure of required step agents per the tiering, including evidence of IV induction when an SC product is specified as 'use after IV only'.
Document prior steps and product identity
Document prior steps tried and product identity when requesting authorization (e.g., evidence that required induction IV agents were used before switching to SC formulations noted as 'use after IV only').
Document prior step use and induction dosing
Prescribers should document prior use of preferred step-therapy agents and whether IV induction dosing was given when required; many agents are noted 'use after IV only' or 'IV (induction)'.
Required drug identification
Documentation should identify the specific formulation (IV vs SC), product name, and when applicable the NDC prefix (for example, adalimumab-adbm NDCs starting with 00597).
Documentation needed
Prescribing and prior authorization requests should reference the applicable step therapy tier list and include any specified NDC (for adalimumab-adbm, NDCs starting with 00597) when relevant.
Required medication details
Document the prescribing route (IV vs SC) and any specified NDC prefix for adalimumab-adbm to demonstrate the requested product matches the tier requirements.
Document step therapy adherence
Prescribers must reference the policy's step therapy tiers when requesting coverage for listed IV and SC biologic agents for Crohn's disease; include evidence of previous steps where required.
Agent, route, and 'use after IV only' notes
Policy lists specific agents and indicates route (IV vs SC) and notes when SC use is only after IV (e.g., Stelara, Steqeyma, Yesintek, Omvoh, Skyrizi, Tremfya); document agent, route, and any 'use after IV only' intent.
Documentation to include
When requesting authorization include agent, administration intent (induction vs maintenance), route, and any prior biologic trials; for adalimumab-adbm include NDC information when applicable.
Document route and product NDC when applicable
Products identified by route (IV vs SC) and, for adalimumab-adbm, by NDC prefix (00597) are listed in the policy — document route and product NDC when relevant to the PA request.
Denial triggers
Failure to meet site-of-service medical necessity criteria or the medical benefit review requirements may result in denial for IV and injectable drugs listed in this policy.
Step sequence adherence
Requests that do not follow the listed step therapy tier sequence (tiers 1–7) may be denied if not consistent with the policy's step therapy requirements.
Step therapy ordering requirements
Coverage and prior authorization may be conditioned on adherence to the listed step therapy tiers; use of products out of stated tier order (for example, initiating an SC agent designated 'use after IV only' without IV induction) may trigger denial.
Step order required
Failure to follow the listed step therapy tier sequence may result in prior authorization denial.
Non-adherence to step therapy tiers
Failure to follow the listed step therapy tiers and induction-use sequencing for SC and IV biologic/biosimilar agents may trigger denial of coverage.
Step therapy noncompliance
Coverage may be denied if treatment selection does not follow the listed step therapy tiers for Crohn's Disease second-line agents.
Step therapy noncompliance
Coverage is contingent on adherence to step therapy tiers; failure to follow the listed step therapy sequence for Crohn's Disease second-line agents may trigger denial.
Step therapy noncompliance
Failure to follow the step therapy tier sequence for listed biologics may trigger denial when the plan requires step adherence.
Step therapy nonconformance
Failure to follow the listed step therapy tiers may trigger denial of coverage for the specified agents.
Step therapy sequencing may affect coverage
Coverage determinations follow step therapy tiers; failure to follow listed step therapy sequencing for second-line biologics for Crohn's disease may trigger denial or require additional prior authorization review.
Step edits may deny non-concordant agents
Use of agents out of step (not following the step therapy tiers) may trigger coverage edits; the policy repeatedly presents agents as 'use after IV only' or as induction (IV) versus SC maintenance.
Background
Inflammatory bowel disorders (primarily Crohn’s disease and ulcerative colitis) are chronic inflammatory conditions of the digestive tract treated with a range of pharmacologic agents, including IV biologics, SC biologics, biosimilars, and targeted oral therapies. This policy defines site‑of‑service medical necessity for infusion administration, enumerates step‑therapy tiers for first‑line and second‑line biologic agents, and specifies sequencing rules such as IV induction followed by SC maintenance where indicated. Providers should follow the tiered sequencing, document prior therapies and induction dosing when required, and include product identifiers (for example, NDC prefix 00597 for adalimumab‑adbm) when relevant to prior authorization requests.
Definitions
Revision History
Policy effective date updated to Aug 1, 2026 with last revised date Jul 27, 2026.
Policy last revised; document history and multiple coverage and coding updates recorded on Jul 27, 2026.
Cyltezo (adalimumab-adbm) changed from preferred to non-preferred; Yuflyma discontinued; various adalimumab and infliximab product statuses updated effective Jan 2, 2026.
Omvoh and Velsipity moved from non-preferred to preferred; Tremfya SC clarified as brand step therapy option for Entyvio SC and Zeposia; other product status updates effective Jan 1, 2025.
Multiple adalimumab biosimilars and infliximab product status changes and step-therapy updates took effect Jan 1, 2024; Avsola moved to preferred infliximab list for 01/01/2024.
Added multiple adalimumab biosimilars and updated preferred/non-preferred statuses and added Velsipity coverage; changes effective July 1, 2023.
Updated step-therapy and site-of-service rules including addition of infliximab (Janssen) and Rinvoq criteria; changes effective Jan 1, 2022.
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