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Cellular Immunotherapy for Prostate Cancer
Blue Cross & Blue Shield of Mississippi·MS · Oncology, Urology·Medical Policy
We identified it
Jun 20, 2026
Summary
This is an updated medical policy for Sipuleucel-T (Provenge) therapy for prostate cancer. The policy maintains coverage for asymptomatic or minimally symptomatic, castration-resistant metastatic prostate cancer cases while considering it investigational for all other situations.
Action Required
Review current Sipuleucel-T (Provenge) claims to ensure they meet medical necessity criteria: patient must have asymptomatic or minimally symptomatic, castration-resistant metastatic prostate cancer. Claims for hormone-responsive prostate cancer or moderate-to-severe symptomatic cases will be denied as investigational.