High impact
Atezolizumab (Tecentriq®)
BCBS Tennessee·Effective Sep 30, 2026
This is a new comprehensive medical policy for Atezolizumab (Tecentriq®) that establishes coverage criteria, prior authorization requirements, and documentation standards across multiple cancer indications including NSCLC, SCLC, HCC, melanoma, mesothelioma, and others. The policy requires prior authorization with specific genetic/molecular testing documentation and grants 6-month authorization periods for covered indications. Do NOT implement until 9/30/26.