CommercialCoverageMedium impact
08.02.45, Telisotuzumab vedotin-tllv (Emrelis™)
Independence Blue Cross·Oncology, Pharmacy·Pharmacy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
This is a new pharmacy policy for Telisotuzumab vedotin-tllv (Emrelis™), a new therapeutic agent. The policy establishes coverage, billing, and clinical guidelines for this medication effective October 1, 2025. The billing team must identify the specific HCPCS drug code and any associated prior authorization or documentation requirements once the full policy text is reviewed.
Action Required
By October 1, 2025: Billing team must obtain and review the complete policy text from the provided URL to identify: (1) the specific HCPCS J-code or C-code for Telisotuzumab vedotin-tllv, (2) any prior authorization requirements, (3) covered indications and patient populations, and (4) any documentation requirements. Update billing system with the correct drug code and clinical criteria. Train billing and clinical staff on coverage requirements and coding. Coordinate with providers to ensure claims include required clinical documentation.