Payer PolicyActive
Autologous Platelet-Derived Growth Factors (Platelet-Rich Plasma [PRP]) - (0507)
CIGNA-0507
Cigna
Effective: October 15, 2025
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
Cigna considers autologous platelet-derived growth factors/platelet‑rich plasma (including CPT 0232T and HCPCS G0460) experimental, investigational, or unproven for ALL indications and does not support coverage. Claims will be denied if not submitted with covered diagnosis/procedure codes, and coverage ultimately depends on the member’s specific benefit plan, applicable laws/regulations, and appropriate coding/documentation of medical necessity.
Coverage Criteria Preview
Key requirements from the full policy
"No uses are covered — "The use of autologous platelet-derived growth factors (CPT® Code 0232T; HCPCS Codes G0460) for ANY condition or indication ."
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