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CommercialCoverageMedium impact

Tezspire (tezepelumab-ekko)

Blue Cross & Blue Shield of Mississippi·MS · Pulmonology, Allergy & Immunology, Family Medicine +2 more·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

BCBS Mississippi updated their policy on Tezspire (tezepelumab-ekko) for severe asthma treatment, confirming it remains not medically necessary due to other covered treatment options. The policy was recently reviewed by their Pharmacy & Therapeutics Committee and sources were updated.

Action Required

Action needed
Immediately: Billing team must verify formulary coverage before prescribing Tezspire (tezepelumab-ekko) by performing drug search on patient's member ID. Do not bill CPT J2356 for injection without prior authorization approval through BCBSMS PA review process. Claims for administration services will be denied if medication is not pre-approved. For State Health Plan members, check formulary at dfa.ms.gov/cvs-caremark and submit PA requests to their Pharmacy Benefit Manager.

Affected Billing Codes

J2356
Tezspire (tezepelumab-ekko) | Blue Cross & Blue Shield of Mississippi | PolicyChanges.app