Amtagvi (lifileucel) - Medicare Advantage

This policy covers Amtagvi (lifileucel), a single‑dose autologous tumor‑infiltrating lymphocyte (TIL) infusion, for the treatment of unresectable or metastatic melanoma in adults. Coverage is limited to patients ≥18 years who have received prior PD‑1 inhibitor therapy (and, if BRAF V600 mutation‑positive, prior BRAF inhibitor with or without a MEK inhibitor), is subject to Medicare “reasonable and necessary” requirements and medical director review, and is not indicated for other tumor types or when prior‑therapy criteria are unmet.

"Previously treated disease (implicit: patient must have received prior systemic therapy)."

Sign up to see full coverage criteria, indications, and limitations.