Allogeneic Processed Thymus Tissue–agdc (Rethymic) (CPB 1055, reviewed 2025-12-23)
Aetna considers a single administration of allogeneic processed thymus tissue-agdc (Rethymic) medically necessary for immune reconstitution in members 18 years of age or younger with congenital athymia when all criteria are met. Aetna considers all other indications experimental, investigational, or unproven. Members with severe combined immunodeficiency (SCID), preexisting cytomegalovirus or HIV infection, or any prior thymus tissue transplantation or Rethymic treatment are not eligible.