CommercialPrior AuthMedium impact
Tezepelumab-ekko (Tezspire®)
BCBS Tennessee·TN · Allergy & Immunology, Pulmonology, ENT (Ear, Nose & Throat)·Medical Policy
Effective date
Jun 30, 2026
We identified it
Jun 17, 2026
Summary
BlueCross BlueShield of Tennessee is implementing a new medical policy for Tezepelumab-ekko (Tezspire®) effective June 30, 2026, establishing prior authorization requirements for this biologic medication used to treat severe asthma and chronic rhinosinusitis with nasal polyps in patients 12 years and older. The policy requires specific prescriber specialties and detailed documentation of previous treatment failures.
Action Required
By June 30, 2026: Billing team must implement prior authorization requirements for Tezepelumab-ekko (Tezspire®) prescriptions. Update billing system to flag when prescribed by allergist/immunologist, pulmonologist, or otolaryngologist for patients 12+ with severe asthma or chronic rhinosinusitis with nasal polyps. Train staff on documentation requirements including previous medication trials, endoscopy results, and clinical scores. Ensure providers document treatment history and clinical criteria before submitting prior auth requests to avoid claim denials.