MedicaidCoverageMedium impact
Amtagvi (lifileucel) - MEDICAID - KENTUCKY (New)
Humana·KY · Oncology·Medicaid
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid in Kentucky has established a new policy for Amtagvi (lifileucel), an autologous tumor-derived T cell immunotherapy for advanced melanoma. All requests require medical director review through the Corporate Transplant Department, with strict eligibility criteria including prior treatment failures.
Action Required
Immediately: For any Amtagvi (lifileucel) requests, billing team must contact Humana Corporate Transplant Department at 1-866-421-5663 or transplant@humana.com for medical director review BEFORE administering treatment. Update billing system to flag codes C9399, J3490, J3590, XW033L7, and XW043L7 for prior authorization when treating Kentucky Medicaid members with melanoma. All claims without prior approval will be denied.