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Pharmacy Policies Available Online

Blue Cross Blue Shield of North Dakota (BCBSND) continually develops and revises pharmacy policies in response to rapidly changing pharmaceutical requirements. Our commitment is to update the provider community as pharmacy policies are adopted and/or revised.

Commercial Updates - Medical Pharmacy

The following Commercial prior authorization medical drug policies are new and effective Dec. 1, 2026:
*see www.gatewaypa.com/policydisplay/52 on or after Dec. 1, 2026.

  • Fayuvi (rebisufligene etisparvovec-hopf)
  • Genglycos (parigalsgene brecaparvovec-opnr)
  • Isembyld (apitegromab-mstn)
  • Pasatru (garetosmab-grts)
  • Zanvastro (zilganersen)

Medicaid Expansion Updates - Medical Pharmacy

Note: There may be corresponding policies for our Commercial lines of business.

The following Medicaid Expansion prior authorization medical drug policies have revisions effective Oct. 1, 2026:

  • Pivekimab Sunirine-pvzy (Decnupaz)
    • Updated HCPCS code C9313
  • Trabectedin (Yondelis, Evdi)
    • Updated HCPCS code Evdi (C9312)
    • Updated HCPCS code Yondelis (J9362)