Site of Care Infusion Drugs

January 1, 2023

Blue Cross Blue Shield of Wyoming site of care program requires certain services that may have been received in a hospital setting to now only be authorized in the most cost-effective setting, such as an infusion center, provider’s office, or via home health. If needed, BCBSWY will assist members with finding an appropriate site for care.

Please note, this site of care program does not affect your prescription drug benefits.

If a member is affected by this program, it will be noted in the authorization letter. 

If administration of the list of drugs below are not approved to be performed in an inpatient or outpatient hospital setting members can receive infusion treatments at facilities such as free-standing infusion center, doctor’s office, pharmacy, or via home health. Failure to receive the service in an approved location could result in the denial of claims.

Please be advised that while the service has been approved as medically appropriate, the member’s benefits require this service be provided in specific locations.

If needed, our Site of Care Team can assist members with finding an appropriate site for care. Our team is available Monday-Friday, 8:00 am-5:00 pm, by calling 307-823-6095 to assist you.

Biosimilar Medications

Please note biosimilar medications that have active properties similar to the brand name medications listed are also included in the site of care program.

The list below has the medications that are subject to the site of care program for administration in the most cost-effective setting.

This program will go into effect with new prescriptions or upon authorization renewal. Typically, medical authorizations expire one year from the date of the authorization.

Questions:
We have a Site of Care Team. If you’re currently taking one of these medications and have questions or concerns, please call 307-823-6095.

Availity Provider Portal
Submit Prior Authorization requests online.
Site of Care Form
Submit an exemption form.
Provider Resources

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