CommercialCoverageMedium impact
08.01.69e, Atezolizumab (Tecentriq®) and Atezolizumab with Hyaluronidase-tqjs (Tecentriq Hybreza TM)
Independence Blue Cross·Oncology, Pharmacy·Pharmacy
Effective date
Apr 1, 2025
We identified it
Jun 19, 2026
Summary
Policy 08.01.69e establishes coverage and billing guidelines for Atezolizumab (Tecentriq®) and Atezolizumab with Hyaluronidase-tqjs (Tecentriq Hybreza™), effective immediately. This is a recent pharmacy policy (1 month old) that the billing team must implement for all claims submitted on or after April 1, 2025.
Action Required
By April 1, 2025: Billing team must obtain and review the complete policy text at https://medpolicy.ibx.com/ibc/Commercial/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=04&FilterField2=MPSiteActivityLogYear&FilterValue2=2025#commercial-08-01-69e to identify specific HCPCS drug codes, prior authorization requirements, coverage limitations, and medical necessity criteria. Update billing system rules, prior authorization workflows, and claim submission templates accordingly. Communicate coverage requirements to oncology providers and infusion center staff. Claims submitted without adherence to this policy will be subject to denial or recoupment.