CommercialCoverageMedium impact
Tecelra (afamitresgene autoleucel)
Blue Cross & Blue Shield of Mississippi·MS · Oncology, Hematology·Medical Policy
Effective date
Jun 3, 2025
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield of Mississippi has added a new policy designating Tecelra (afamitresgene autoleucel), a specialized CAR-T cell therapy for synovial sarcoma, as investigational and not covered. This is an expensive cellular therapy that requires prior chemotherapy and specific genetic markers, and all related services including administration will be denied.
Action Required
By June 3, 2025: Update billing system to flag HCPCS code Q2057 as non-covered/investigational for BCBS Mississippi plans. Train billing staff that Tecelra and all related administration services will be denied. Verify patient's formulary coverage before treatment as this policy may not apply to all benefit plans.