Medicare AdvantagePrior AuthMedium impact
MA08.166a, Talquetamab-tgvs (Talvey®)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
May 4, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.166a for Talquetamab-tgvs (Talvey®) has been updated with new medical necessity criteria and medical coding requirements. This affects billing and coverage determinations for this specialty pharmaceutical drug used in cancer treatment.
Action Required
Before May 4, 2026: Billing team must review updated medical necessity criteria for Talquetamab-tgvs (Talvey®) at the provided policy URL. Update prior authorization procedures and documentation requirements for this drug. Ensure coding staff are aware of any new medical coding requirements that may affect claim submission.