Carvykti requires prior authorization for Medicare Advantage members

For dates of service on or after March 7, 2022, Carvykti™ (ciltacabtagene autoleucel), HCPCS code J9999, requires prior authorization for Medicare Plus Blue℠ and BCN Advantage℠ members. Prior authorization is required for all sites of care in which this drug is administered.

Submit requests for this drug using the NovoLogix^® online tool. It offers real-time status checks and immediate approvals for certain medications. If you have access to the Availity^® Essentials provider portal, you already have access to NovoLogix. If you need to request access to Availity, follow the instructions on the Register for web tools webpage at bcbsm.com/providers. After you’ve logged in to Availity, click on Payer Spaces and then click on the BCBSM and BCN logo. This will take you to the Blue Cross and BCN payer space, where you’ll find links to the NovoLogix tools on the Applications tab.

For a list of requirements related to drugs covered under the medical benefit, see the Medical Drug and Step Therapy Prior Authorization List for Medicare Plus Blue PPO and BCN Advantage members.

We’ve updated the list to reflect these changes.