CommercialPrior AuthMedium impact
Teclistamab-cqyv (Tecvayli™)
BCBS Tennessee·TN · Oncology, Hematology·Medical Policy
Effective date
Jul 31, 2026
We identified it
Jun 17, 2026
Summary
BlueCross BlueShield of Tennessee is implementing a new medical policy for Teclistamab-cqyv (Tecvayli™), a specialty oncology drug for multiple myeloma and related conditions. The policy establishes prior authorization requirements and coverage criteria for this expensive biologic therapy.
Action Required
Before July 31, 2026: Billing team must prepare for new prior authorization requirements for Teclistamab-cqyv (Tecvayli™). Update billing system to flag this drug for prior auth. Train staff to collect required documentation including chart notes or medical records demonstrating failure of previous therapies. Ensure providers document specific prior therapy failures and treatment combinations per policy criteria. Claims without proper prior authorization will be denied.