Spravato and Panzyga to require prior authorization starting July 12 for Blue Cross URMBT non-Medicare members

We’re expanding the prior authorization requirements for drugs covered under the medical benefit for UAW Retiree Medical Benefits Trust, or URMBT, commercial (non-Medicare) members with Blue Cross Blue Shield of Michigan coverage.

For dates of service on or after July 12, 2021, the following drugs will require prior authorization:

• Spravato^® (esketamine), HCPCS code S0013  
• Panzyga^® (immune globulin, human-ifas), HCPCS code J1599

How to submit authorization requests

Submit prior authorization requests through the NovoLogix^® online tool. It offers real-time status checks and immediate approvals for certain medications.

To learn how to submit requests through NovoLogix, do the following:

1. Visit ereferrals.bcbsm.com.
2. Click on Blue Cross.
3. Click on Medical Benefit Drugs.
4. Scroll down to the Blue Cross’ PPO (commercial) column.
5. Review the information in the How to submit requests electronically using NovoLogix section.

More about the authorization requirements

Authorization isn’t a guarantee of payment. As always, health care practitioners need to verify eligibility and benefits for members.

For additional information on requirements related to drugs covered under the medical benefit, refer to the document Medical Drug Management with Blue Cross for UAW Retiree Medical Benefit Trust PPO non-Medicare members.

We’ll update this list with the new information about these drugs prior to the effective date.