Alopecia Areata

Covered: topical anthralin and topical or intralesional glucocorticoids for mild alopecia areata (<50% scalp hair loss); for extensive disease (>50% scalp loss) covered therapies include topical anthralin, oral/topical/intralesional glucocorticoids and psoralen photochemotherapy (PUVA — per CPB 0205); numerous other therapies/tests listed (e.g., biologics, immunosuppressants, PRP, lasers, many lab/genetic tests) plus specific CPT/HCPCS codes are considered experimental/investigational and not covered, and androgenic alopecia (ICD‑10 L64.9) is excluded. Key requirements: coverage is contingent on disease extent (<50% vs >50% scalp hair loss) and PUVA must follow CPB 0205; all therapies/tests and procedure/drug codes listed as experimental/investigational are not covered.

"Extensive alopecia areata (involving more than 50 % loss of scalp hair) — treatments may include topical immunotherapy, systemic agents or other measures: "Therapy for extensive alopecia areata (in..."