CommercialCoverageMedium impact
Radioembolization (TARE) for Hepatic Tumors 7.01.69
Excellus BlueCross BlueShield·Oncology, Gastroenterology, Radiology +1 more·Radiation Treatment
Effective date
Feb 19, 2026
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has updated their policy for Transarterial Radioembolization (TARE) for hepatic tumors, defining specific medical necessity criteria for primary and metastatic liver tumors. The policy establishes coverage requirements for initial TARE treatments and limits repeat treatments to a maximum of two procedures with strict criteria.
Action Required
Before February 19, 2026: Billing and clinical teams must review all TARE procedures to ensure they meet the new medical necessity criteria including ECOG performance status ≤2, adequate liver function, and life expectancy >3 months. Update prior authorization processes to verify coverage criteria for hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and specified metastatic tumors. Ensure documentation supports that patients are not candidates for other treatments when billing for metastatic cases.