All PlansPrior AuthMedium impact
Nivolumab and Hyaluronidase-nvhy (Opdivo Qvantig™)
BCBS Tennessee·Oncology, Hematology·Medical Policy
Effective date
Jun 30, 2026
We identified it
Jun 17, 2026
Summary
New coverage policy for Opdivo Qvantig (nivolumab and hyaluronidase-nvhy), a subcutaneous formulation of nivolumab for various cancer treatments including renal cell carcinoma, melanoma, lung cancer, and other oncology indications. Prior authorization required with specific coverage criteria for each indication.
Action Required
Before June 30, 2026: Oncology billing teams must prepare for prior authorization requirements for Opdivo Qvantig. Update prior auth workflows to include required documentation such as MSI-H/dMMR tumor status reports and EGFR/ALK mutation testing where applicable. Note exclusion for patients who progressed on prior PD-1/PD-L1 inhibitor therapy. Review coverage criteria for specific authorization periods (3-6 months) based on indication and treatment setting.