Immune Globulin Therapy (IVIG and SCIG)
Defines medical necessity, site-of-service review, indications, investigational uses, documentation and coding for intravenous and subcutaneous immune globulin therapies for Premera members.
Added Qivigy (immune globulin intravenous, human-kthm) to the policy and new HCPCS code J1553.
Updated coverage criteria for antiphospholipid syndrome to be medically necessary for catastrophic antiphospholipid syndrome when plasma exchange is not an option and IVIG is not used as chronic or prophylactic therapy.
Updated Guillain-Barré syndrome criteria to include severe disease with significant weakness and initiation of treatment within 4 weeks of symptom onset.
Updated multifocal motor neuropathy criteria to require stepwise or slowly progressive asymmetric limb weakness ≥1 month and specific nerve conduction study findings.
Updated neuromyelitis optica spectrum disorder criteria to include diagnosis confirmed by one clinical characteristic.
Added site of service review for Yimmugo and previously added site-of-service reviews for multiple products (Asceniv, Cutaquig, Panzyga, Alyglo) throughout history.
Updated IgG level requirements from <400 mg/dL to <500 mg/dL across initial criteria and added re-authorization requirement to have an IgG ≥300 mg/dL.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.