Medicare AdvantagePrior AuthMedium impact
MA08.141d, Tisotumab vedotin-tftv (Tivdak®)
Independence Blue Cross·Oncology·Pharmacy
Effective date
Jun 16, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage updated their policy for Tisotumab vedotin-tftv (Tivdak®), a cancer medication, with changes to medical necessity criteria, medical coding requirements, and general guidelines. This affects billing and coverage determination for this specialty oncology drug.
Action Required
By June 16, 2025: Billing team must review updated medical necessity criteria for Tisotumab vedotin-tftv (Tivdak®) and update prior authorization requirements in billing system. Providers must ensure documentation meets new medical necessity standards. Access full policy details at the source URL to implement specific coding and coverage changes.