All PlansCoverageMedium impact
Somatic Biomarker Testing for Immune Checkpoint Inhibitor Therapy (BRAF, MSI/MMR, PD-L1, TMB)
Blue Cross & Blue Shield of Mississippi·MS · Oncology, Hematology, Pathology·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS MS has updated their medical policy for somatic biomarker testing used to guide immune checkpoint inhibitor therapy for cancer patients. The policy covers FDA-approved companion diagnostic tests for BRAF, MSI/MMR, PD-L1, and TMB biomarkers that predict response to immunotherapy treatments.
Action Required
Immediately: Billing team should review current biomarker testing claims for cancer patients receiving immunotherapy to ensure they align with FDA-approved companion diagnostic requirements outlined in the updated policy. Verify that BRAF V600, dMMR/MSI-H, PD-L1, and TMB testing requests are appropriate for the specific immune checkpoint inhibitor therapy being considered. Update prior authorization workflows to reference the new policy guidelines when submitting requests for these biomarker tests.