Site of service restrictions applied for infusion services July 1

Effective Jul. 1, 2022, we'll begin applying site of service restrictions for oncology medication administration in accordance with our infusion services medical policy.

What's changing?

Beginning July 1, infusions for select oncology medications must be administered at preferred sites of care, according to the member's plan. If a non-preferred site of care is utilized after July 1, the claim will deny.

This change is in alignment with our existing medical policy. For medications in this policy, commercial members are required to receive infusion services in the home, an office setting or a Priority Health-approved site of service. For more information, reference Medical Benefit Drug List.

Infusions impacted

On July 1, the site of service requirement is being applied to the following medications:

  • Keytruda
  • Opdivo
  • Libtayo
  • Tecentriq
  • Bavencio
  • Imfinzi
  • Yervoy

What you need to do? 

If you have members 18 and older scheduled for infusion services at your location or facility, be sure you are the preferred site of service for their plan.

Pediatric and adolescent commercial members can continue infusions at their current site of service.