Draft Medical Policies
BlueCross BlueShield of Tennessee

BlueCross BlueShield of Tennessee works to ensure that Medical Policies are developed in an open, collaborative manner with our providers. We invite you to submit comments during the development phase of our Medical Policies.

Medical policies are developed using an evidence-based evaluation process. The medical evidence used in this process comes from several sources, including independent medical technology review organizations, the peer reviewed medical literature, and expert opinions from BCBST network specialists. We especially welcome comments that include this type of information. All Medical Policies are reviewed and approved by a panel of BCBST Medical Directors as well as board certified network physicians before final adoption by the company.


Policy Posted
Policy Removed
DMP0719-22 Aflibercept 07/24/19 08/24/19
DMP0719-23 Atezolizumab 07/24/19 08/24/19
DMP0719-24 Plasma Exchange 07/29/19 08/29/19
DMP0719-25 Infliximab 07/31/19 08/31/19
DMP0719-26 Infliximab-abda 07/31/19 08/31/19
DMP0719-27 Infliximab-dyyb 07/31/19 08/31/19
DMP0819-01 Rituximab 08/02/19 09/02/19
DMP0819-02 Rituximab-abbs 08/02/19 09/02/19
DMP0819-03 Rituximab-pvvr 08/02/19 09/02/19
DMP0819-04 Bendamustine HCl ready-to-dilute 08/07/19 09/07/19
DMP0819-05 Subcutaneous Immune Globulins 08/07/19 09/07/19
DMP0819-06 Bevacizumab for the Treatment of Neoplastic Disease 08/08/19 09/08/19
DMP0819-07 Bevacizumab Biosimilar Products for the Treatment of Neoplastic Disease 08/08/19 09/08/19
DMP0819-08 Daratumumab 08/08/19 09/08/19
DMP0819-09 Testing Serum Vitamin D Levels 08/12/19 09/12/19
DMP0819-10 Testosterone Testing (Total, Free) 08/14/19 09/14/19
DMP0819-11 Pembrolizumab 08/15/19 09/15/19
DMP0819-12 Eculizumab 08/15/19 09/15/19
DMP0819-13 Breast Cancer Gene Expression Assays 08/15/19 09/15/19
DMP0819-14 Lanreotide 08/20/19 09/20/19


Medical Policy Comments:

Please reference the policy name or tracking number in your comments.
To submit comments about the draft Medical Policies:
Click the “Medical Policy Comments” above or click here: Comments or Feedback.

Comments can also be mailed to:

BlueCross BlueShield of Tennessee
Medical Policy
1 Cameron Hill Circle
Chattanooga, TN 37402