Treatment of Males with Low Testosterone

Testosterone therapy is covered only for men with clinically significant symptoms of androgen deficiency combined with confirmatory laboratory testing (two separate morning testosterone measurements and a single LH/FSH). Primary hypogonadism (low testosterone with elevated LH/FSH) is an indication, whereas low serum testosterone alone or use in men with breast cancer, untreated prostate cancer, or those desiring fertility is not covered; risks and monitoring (including baseline PSA and discussion of thromboembolic and hematologic risks) must be documented.

"Testosterone replacement may be considered for men with clinically significant symptoms of androgen deficiency AND two separate morning serum total testosterone levels low on two different days and..."

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