This information is intended for U.S. healthcare professionals and/or
healthcare professionals involved in healthcare reimbursement.
This site is intended for U.S. residents 18 years of age or older.
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Supporting patient access
BMS Access Support® may help support patient access by conducting benefits reviews and offering prior authorization and appeals process assistance for enrolled patients. Additionally, the information below provides product-specific billing and diagnosis codes, reimbursement and coding guides, distribution information, and additional coverage support offerings. To view available coding and coverage information, please select your patient’s prescribed medication.
Additional eligibility criteria and terms may apply. Bristol Myers Squibb and its agents make no guarantee regarding reimbursement for any service or item.
Read more about our coverage support offerings
Benefits Reviews
- Once a patient is enrolled in BMS Access Support, we can review their insurance coverage and provide a summary of benefits within approximately 24 hours*
- A benefits review may help determine whether or not a medication is covered, if a PA is required, and estimated patient out-of-pocket costs
*BMS Access Support Data - Benefits review. Accessed August 2022.
Prior Authorization (PA) and Appeals Assistance
- Use the BMS Access Map to identify plan-specific PA requirements
- View our forms and resources page for helpful support tools, including appeals letter templates and medical necessity letters
Annual Reverification
- Reverification of benefits is available upon request to confirm a patient’s benefits for the new year
- Connect with your local Access and Reimbursement Manager for more information
The accurate completion of reimbursement- or coverage-related documentation is the responsibility of the healthcare provider and patient. Bristol Myers Squibb and its agents make no guarantee regarding reimbursement for any service or item.
Reimbursement and Coding Guide
for REVLIMID
Select Your Patient’s Condition
Filter results by:
National Drug Codes (NDC)1
Issued by the FDA
| 59572-0402-28 Copy | 2.5 mg bottles of 28 capsules |
| 59572-0402-00 Copy | 2.5 mg bottles of 100 capsules |
| 59572-0405-28 Copy | 5 mg bottles of 28 capsules |
| 59572-0405-00 Copy | 5 mg bottles of 100 capsules |
| 59572-0410-28 Copy | 10 mg bottles of 28 capsules |
| 59572-0410-00 Copy | 10 mg bottles of 100 capsules |
| 59572-0415-21 Copy | 15 mg bottles of 21 capsules |
| 59572-0415-00 Copy | 15 mg bottles of 100 capsules |
| 59572-0420-21 Copy | 20 mg bottles of 21 capsules |
| 59572-0420-00 Copy | 20 mg bottles of 100 capsules |
| 59572-0425-21 Copy | 25 mg bottles of 21 capsules |
| 59572-0425-00 Copy | 25 mg bottles of 100 capsules |
International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)2
Coding for REVLIMID is dependent on the insurer and the care setting in which the drug will be administered. Oncology practices need to make coding decisions based on the diagnosis and treatment of each patient and the specific insurer requirements.
Please see U.S. Full Prescribing Information for REVLIMID, including Boxed WARNINGS.
*Healthcare providers should code healthcare claims based upon the service that is rendered, the patient’s medical record, the coding requirements of each health insurer, and best coding practices. Coding guidance provided under this heading does not provide a guarantee of reimbursement and should be considered together with all applicable coding guidance and standards. All of the coding information presented by this website is applicable to outpatient procedures only.
References:
- REVLIMID [package insert]. Princeton, NJ: Bristol-Myers Squibb Company.
- Centers for Medicare & Medicaid Services. ICD-10-CM tabular list of diseases and injuries. https://www.cms.gov/Medicare/Coding/ICD10/2023-ICD-10-CM. Accessed July 5, 2023.
Select Your Patient’s Condition
Prescribers and pharmacies must be certified with the Lenalidomide REMS program by enrolling and complying with the REMS requirements; pharmacies must only dispense to patients who are authorized to receive REVLIMID. The REMS-Pharmacy Network list includes specialty pharmacies that are contracted to fill prescriptions for restricted distribution programs for Bristol Myers Squibb.
Specialty Pharmacies
| Pharmacy | Phone | Fax |
|---|---|---|
| Absolute Pharmacy | 1-787-892-8700 | 1-787-496-1010 |
| AcariaHealth Pharmacy | 1-866-458-9246 | 1-866-458-9245 |
| Accredo Specialty Pharmacy | 1-877-732-3431 | 1-800-590-1021 |
| ACS Advanced Care Scripts | 1-877-985-6337 | 1-866-679-7131 |
| AllianceRx Walgreens Prime | 1-888-347-3416 | 1-877-231-8302 |
| Amber Specialty Pharmacy | 1-888-370-1724 | 1-877-645-7514 |
| Axium Healthcare Puerto Rico | 1-787-780-7200 | 1-800-546-2163 |
| Biologics by McKesson | 1-800-850-4306 | 1-800-823-4506 |
| Biomatrix | 1-888-662-6779 | 1-877-800-4790 |
| BioPlus Specialty Pharmacy | 1-888-292-0744 | 1-800-269-5493 |
| CareMed Specialty Pharmacy | 1-877-227-3405 | 1-877-542-2731 |
| CVS Specialty | 1-800-237-2767 | 1-800-323-2445 |
| Farmacia San Rafael | 1-787-724-3333 | 1-787-721-4165 |
| Humana Specialty Pharmacy | 1-800-486-2668 | 1-877-405-7940 |
| Kroger Specialty Pharmacy | 1-888-327-2962 | 1-888-315-3270 |
| Magellan Rx Pharmacy (ICORE) | 1-866-554-2673 | 1-866-364-2673 |
| Onco360 | 1-877-662-6633 | 1-877-662-6355 |
| Optum Specialty Pharmacy | 1-877-445-6874 | 1-866-306-5231 |
| RxCrossroads by McKesson (VA Dispensing) | 1-855-637-9433 | 1-855-637-9446 |
| Special Care Pharmacy Services | 1-787-781-4885 | 1-787-783-2951 |
| Upstate Pharmacy | 1-800-314-4655 | 1-800-314-7756 |
| US Bioservices | 1-877-757-0667 | 1-888-899-0067 |
Above information is accurate as of 08/23.
The REVLIMID distribution program includes extended payment terms to Bristol Myers Squibb authorized REVLIMID distributors. Healthcare providers and institutions should contact their REVLIMID distributor to understand specific payment terms that may be available to them from their distributor.
Please see U.S. Full Prescribing Information for REVLIMID, including Boxed WARNINGS.
Select Your Patient’s Condition
Please see U.S. Full Prescribing Information for REVLIMID, including Boxed WARNINGS.
