Medicare AdvantageCoverageLow impact
Lenmeldy (atidarsagene autotemcel) - Medicare Advantage (Revised)
Humana·Pediatrics, Neurology, Genetics +1 more·Medicare Advantage
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now covers Lenmeldy (atidarsagene autotemcel), a new gene therapy for treating specific subtypes of metachromatic leukodystrophy in children 17 and younger. All requests require review by a medical director and must be referred to Humana's Corporate Transplant Department at 1-866-421-5663.
Action Required
Before June 1, 2026: Billing team must update system to recognize new HCPCS code J3391 for Lenmeldy gene therapy. For any requests involving this treatment, staff must contact Humana's Corporate Transplant Department at 1-866-421-5663 or transplant@humana.com before proceeding. Update encounter forms to include ICD-10-PCS codes XW133G8 and XW143G8 for the transfusion procedures. All claims require medical director review and pre-approval.