CommercialCoverageMedium impact
State and School Employees' Health Insurance Plan - Tezspire (tezepelumab-ekko)
Blue Cross & Blue Shield of Mississippi·MS · Pulmonology, Allergy & Immunology, Pediatrics·Medical Policy
We identified it
Jun 20, 2026
Summary
The Mississippi State and School Employees' Health Insurance Plan updated their policy for Tezspire (tezepelumab-ekko) injections, specifically changing the drug name from tezepelumab to tezepelumab-ekko. The policy continues to consider this medication not medically necessary for severe asthma treatment, meaning claims for this drug will be denied.
Action Required
Immediately: Billing team must update any references to Tezspire from 'tezepelumab' to 'tezepelumab-ekko' in billing systems and documentation. Continue to expect denials for HCPCS code J2356 (injection, tezepelumab-ekko, 1 mg) as this medication remains not medically necessary. Verify patients have coverage through the State Health Plan's pharmacy benefit instead of medical benefit for this medication.