Chimeric Antigen Receptor (CAR) T-cell Therapy - Medicare Advantage

This policy covers Chimeric Antigen Receptor (CAR) T‑cell therapy, including related collection, processing and administration services as represented by the listed CPT/HCPCS/Q‑codes and specific CAR‑T products (e.g., axicabtagene, tisagenlecleucel, brexucabtagene, lisocabtagene, idecabtagene, ciltacabtagene, obecabtagene). It applies to patients receiving CAR‑T immunotherapy for cancer but is limited to uses deemed "reasonable and necessary" by Medicare and is contingent on meeting individual Humana Pharmacy product coverage criteria and applicable CMS NCDs/LCDs; no specific diagnoses, age/frequency or prior‑treatment requirements are specified in this excerpt.

"38227 - Chimeric antigen receptor T cell (CAR T) therapy; receipt and preparation of CAR T cells for administration"

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