Medicare AdvantageCoverageLow impact
Ryoncil (remestemcel-L-rknd) - Medicare Advantage (New)
Humana·Hematology, Oncology, Pediatrics +1 more·Pharmacy
Effective date
May 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has established a new coverage policy for Ryoncil (remestemcel-L-rknd), a specialized treatment for steroid-refractory acute graft-versus-host disease in pediatric patients. All requests require review by the Corporate Transplant Department with specific medical necessity criteria including age restrictions (2 months to 17 years) and diagnosis requirements.
Action Required
By May 1, 2025: Contact Corporate Transplant Department at 1-866-421-5663 or transplant@humana.com for all Ryoncil (remestemcel-L-rknd) requests. Verify patient meets criteria: diagnosed with steroid-refractory acute graft-versus-host disease, aged 2 months to 17 years, and no contraindications. Use HCPCS code J3402 for billing when effective October 1, 2025. All requests require medical director review.