Medical Policy: Bevacizumab Intravenous
Defines medical necessity criteria, dosing limits, authorization length, renewal criteria, applicable HCPCS/J-codes, NDCs, and a large list of covered ICD-10 cancer diagnoses for bevacizumab (Avastin, Alymsys, Mvasi, Vegzelma, Zirabev) for Commercial, Medicaid, and Medicare members (Medicare has separate LCD/NCD reference).
Annual Review combined Mvasi/Zirabev policy into Bevacizumab; updated dosage limits and added Medicare LCD/NCD note.
Hepatocellular carcinoma criteria reworded to clarify first-line use with atezolizumab and expanded alternative liver-confined/inoperable scenarios with Child-Pugh A or B.
Colorectal cancer criteria extensively revised to remove adjuvant use and add detailed regimen- and biomarker-specific pathways including use with trifluridine/tipiracil after multiple prior regimens.
NSCLC criteria removed ECOG 0-2 requirement and added numerous molecular biomarker-specific combinations including EGFR exon 19/21 with erlotinib and other mutation contexts.
Cervical cancer criteria updated to permit combinations with pembrolizumab and require PD-L1 CPS ≥1 for that combination; allows single-agent subsequent use and use in NECC.
Multiple indication-specific additions (e.g., ovarian maintenance with olaparib/niraparib combinations, mesothelioma first-line pemetrexed+platinum combinations) and removals (e.g., breast cancer and Kaposi sarcoma removed).
Initial approval criteria updated to require oncologist prescribing/consultation and step therapy applies to new starts only.
Added many ICD-10 diagnosis codes and extensive revision history entries spanning 2019-2024.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.