Medicare AdvantageCoverageMedium impact
MA08.127d, Atezolizumab (Tecentriq®) and Atezolizumab with Hyaluronidase-tqjs (Tecentriq Hybreza TM)
Independence Blue Cross·Oncology·Pharmacy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Medical necessity criteria for Atezolizumab (Tecentriq®) and Atezolizumab with Hyaluronidase-tqjs (Tecentriq Hybreza™) have been updated for Medicare Advantage plans. This pharmacy policy change affects coverage requirements for these cancer immunotherapy medications.
Action Required
Immediately: Review updated medical necessity criteria for Atezolizumab prescriptions. Oncology providers and billing team must ensure all prior authorization requests for Tecentriq and Tecentriq Hybreza include documentation meeting the new criteria. Update prior auth checklists and provider reference materials with revised requirements to prevent claim denials.