Umbilical Cord Blood Transplantation - MEDICAID - VIRGINIA

This policy covers umbilical cord blood transplantation using allogeneic cord blood hematopoietic progenitor cell therapies (e.g., Omisirge/omidubicel, Regenecyte) to achieve hematopoietic and immune reconstitution for patients with hematologic malignancies. Coverage is generally limited to individuals (typically age 12–65) planned for UCB transplantation after myeloablative conditioning—often in the absence of a matched bone marrow or peripheral blood donor—administered as a single one‑time infusion at an approved facility and subject to plan-specific criteria and benefit limitations.

"Umbilical cord blood transplantation (policy title indicates coverage subject; no specific covered indications, diagnoses, or clinical scenarios are listed in the provided text)."

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