CommercialCoverageMedium impact
State and School Employees' Health Insurance Plan - Therapeutic Radiopharmaceuticals for Neuroendocrine Tumors
Blue Cross & Blue Shield of Mississippi·Oncology, Nuclear Medicine, Gastroenterology +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
This policy establishes coverage criteria for therapeutic radiopharmaceuticals, specifically Lutetium 177 dotatate, for treating neuroendocrine tumors under the State and School Employees' Health Insurance Plan. The policy provides comprehensive background on neuroendocrine tumors, treatment options, and establishes the framework for peptide receptor radionuclide therapy coverage.
Action Required
Review policy S.6.01.60 for therapeutic radiopharmaceuticals coverage criteria. Billing team should familiarize themselves with neuroendocrine tumor treatment pathways and ensure proper documentation requirements are met for Lutetium 177 dotatate therapy claims. Verify patient eligibility under State and School Employees' Health Insurance Plan before scheduling treatments.