MedicaidPrior AuthMedium impact
Tivdak (tisotumab vedotin-tftv) (New)
Humana·IN · Oncology, OB-GYN·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has introduced a new prior authorization policy for Tivdak (tisotumab vedotin-tftv), an intravenous cancer medication used for recurrent/metastatic cervical cancer. Prior authorization will be required starting October 1, 2025, with specific criteria including disease progression after chemotherapy and administration as monotherapy subsequent therapy.
Action Required
By October 1, 2025: Billing team must update prior authorization requirements for Tivdak (tisotumab vedotin-tftv) infusions for Humana Medicaid Indiana patients. Verify patient meets all four criteria before administration: recurrent/metastatic cervical cancer, disease progression after chemotherapy, medical contraindication to Keytruda if CPS score ≥1, and monotherapy use. Visit www.humana.com/PAL for specific billing codes. Claims will be denied without proper prior authorization.