Stem Cell Transplantation (Formerly 110.8.1)

Medicare covers allogeneic and autologous hematopoietic stem cell transplantation for specific hematologic diseases and genetic immunodeficiencies when criteria are met, including leukemia, aplastic anemia, SCID, Wiskott-Aldrich, specified MDS risk thresholds, and defined indications for AuSCT (e.g., neuroblastoma, resistant NHL, select multiple myeloma cases). Coverage for several indications (allogeneic HSCT for multiple myeloma, myelofibrosis, and sickle cell disease) is limited to beneficiaries enrolled in approved prospective clinical studies meeting CMS Coverage with Evidence Development standards; several other conditions and historical exclusions are explicitly non-covered or delegated to local Medicare Administrative Contractors.

"Allogeneic HSCT is covered for treatment of leukemia, including leukemia in remission, and aplastic anemia (effective for services on or after August 1, 1978)."