Rethymic (allogeneic processed thymus tissue-agdc) - MEDICAID - SOUTH CAROLINA

This policy covers Rethymic (allogeneic processed thymus tissue‑agdc), the FDA‑approved allogeneic thymus implant for immune reconstitution in congenital athymia (including complete DiGeorge and related syndromic/hereditary causes), typically in infants/children identified by newborn SCID screening and confirmed by very low naïve T‑cell counts on flow cytometry and genetic testing. Coverage is limited to Humana members age 17 or younger with confirmed congenital athymia, requires absence of contraindications, is provided as a single surgical dose per lifetime, and is subject to plan eligibility, medical director review and transplant department authorization.

"None specified in the provided text"

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