Rebyota™ (fecal microbiota, live-jslm)

Covered: a single 150 mL rectal dose of Rebyota to prevent recurrent C. difficile infection in adults (≥18) after antibiotic treatment; excluded for patients <18, those without the required diagnostic/episode history, with uncontrolled symptoms, prior Rebyota recipients, or use for acute primary CDI. Authorization requires documented confirmed CDI (≥3 loose stools/24 hr for 2 consecutive days plus positive stool toxin/toxigenic C. difficile test), recurrent-episode criteria (≥3 CDI episodes or ≥2 severe CDI hospitalizations in the past year), current symptom control after ≥10 consecutive days of antibiotics (＜3 loose stools/day for 2 consecutive days), and administration of the single 150 mL dose 24–72 hours after the last antibiotic with supporting documentation.

"Documentation of completion of at least 10 consecutive days of antibiotic therapy for the current CDI."