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Tepezza (teprotumumab-trbw)

Blue Cross & Blue Shield of Mississippi·MS · Endocrinology, Ophthalmology·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

BCBS Mississippi updated their medical policy for Tepezza (teprotumumab-trbw) for Thyroid Eye Disease treatment. The policy establishes strict prior authorization requirements including specific clinical criteria, failed standard therapy requirements, and specialist coordination between endocrinologists and ophthalmologists.

Action Required

Action needed
Immediately: Billing team must implement prior authorization process for all Tepezza infusions. Ensure providers obtain approval before treatment by documenting: patient ≥18 years old, moderate-to-severe active TED diagnosis with CAS ≥4, failed standard corticosteroid therapy, coordination between endocrinologist and ophthalmologist, and euthyroid status. Use network DSP-Pharmacy for medication procurement. Claims will be denied without prior authorization and considered cosmetic.