Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
BCBS TennesseeCommercial · Prior Auth · Medical Policy · TN · Pediatrics, Endocrinology, OB-GYN +1 moreMedium impact

Leuprolide Acetate Depot Suspension (Lupron Depot-Ped®)

Act
by Nov 1, 2026
Effective date
Dec 1, 2026
Identified
Sep 10, 2026

Summary

BlueCross BlueShield of Tennessee is establishing new medical policy for Leuprolide Acetate Depot Suspension (Lupron Depot-Ped®) effective December 1, 2026, covering two indications: FDA-approved use for central precocious puberty (CPP) in pediatric patients, and compendial use for gender dysphoria in adolescents seeking gender-affirming care. The policy requires specific prior authorization criteria, provider specialties, and documentation for both indications, with 12-month authorization periods for initial and continuation therapy.

Get alerts when payers change rules like this one

We check BCBS Tennessee and other payers every day and email you when a change matches your specialty and state.

Get BCBS Tennessee alertsPolicy Monitoring is free. No card required.

What to do

by Nov 1, 2026 · 6 steps
01Billing and prior authorization teams must implement new workflow for Lupron Depot-Ped® claims.
02For CPP cases, require providers to submit laboratory documentation (GnRH agonist test results or pubertal LH levels on third-generation assay) and bone age assessment before authorization.
03For gender dysphoria cases, verify prescriber specialty (pediatric endocrinologist, family medicine, internal medicine, or OB-GYN with mental health collaboration for members under 18) and confirm member meets clinical criteria (Tanner stage 2+, informed consent documented, fertility preservation counseling documented, comorbidities controlled).
04Update authorization system to grant 12-month approvals for initial requests and reauthorizations.
05Flag any requests for members under 18 with gender dysphoria diagnosis for state regulatory review per Tennessee law.
06Train front-desk and authorization staff on new documentation requirements.
If missed: Failure to obtain proper prior authorization will result in claim denials.

Original notice

Leuprolide Acetate Depot Suspension (Lupron Depot-Ped®)
bcbst.com · Always check the source before changing claims.
View original ↗

Related changes

See all BCBS Tennessee changes →
Leuprolide Acetate Depot Suspension [Lupron Depot (1 month) 7.5mg, Lupron Depot (3 month) 22.5mg, Lupron Depot (4-Month) 30 mg, Lupron Depot (6-Month) 45 mg]; Leuprolide acetate depot (3-month 22.5 mg); Lutrate Depot® (3-month 22.5 mg)HighEffective Dec 1, 2026 · Medical PolicyLeuprolide Acetate Depot Suspension (Lupron Depot-Ped®)MediumEffective Sep 30, 2026 · Medical PolicyBrowse every BCBS Tennessee change in the policy list

Related policy hubs

BCBS Tennessee policiesTN policy changesPediatricsEndocrinologyOB-GYNPsychiatry

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account