CommercialCoverageMedium impact
Tumor-Treatment Fields Therapy 6.01.45
Excellus BlueCross BlueShield·Oncology, Neurology, Neurosurgery·Cancer Treatment (Oncology)
Effective date
Apr 16, 2026
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has established specific coverage criteria for Tumor-Treatment Fields (TTF) therapy using the Optune device for glioblastoma multiforme treatment. The policy covers both recurrent and newly diagnosed cases with strict compliance requirements (18+ hours daily use) and requires extensive documentation including pathology confirmation and performance status.
Action Required
By April 16, 2026: Billing team must implement prior authorization requirements for Optune TTF therapy claims. Providers must document all required criteria including histologically confirmed GBM pathology, Karnofsky Performance Status of 60+, patient age 22+, and compliance with 18+ hours daily usage. Create documentation checklist in EMR templates to ensure all criteria are met before billing. Claims without complete documentation will be denied.