Medicare AdvantagePrior AuthMedium impact
Tepmetko (tepotinib) (Revised)
Humana·Oncology, Pulmonology·Medicare Advantage
Effective date
Nov 26, 2025
We identified it
Jun 25, 2026
Summary
Humana updated its Tepmetko (tepotinib) prior authorization policy for Medicare Advantage members with a revision date of November 26, 2025. The policy requires prior authorization for this MET inhibitor in metastatic NSCLC with MET exon 14 skipping mutations. Key approval criteria require documented metastatic NSCLC with confirmed MET exon 14 skipping mutation, and the policy excludes members with prior disease progression on MET inhibitors.
Action Required
By November 26, 2025: Billing and prior authorization teams must ensure Tepmetko (tepotinib) requests for Humana Medicare Advantage members include: (1) Diagnosis confirmation of metastatic NSCLC, (2) Documentation of MET exon 14 skipping mutation status, and (3) Verification that member has NOT experienced disease progression on prior MET inhibitors (capmatinib or tepotinib). Update prior authorization submission checklists and EMR templates to capture these required documentation elements. Claims submitted without this documentation will be denied. Oncology practices should brief prescribers on these criteria before submitting requests to Humana.