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Kebilidi (eladocagene exuparvovec-tneq) - Medicare Advantage (Revised)

Humana·Neurosurgery, Neurology, Genetics +1 more·Medicare Advantage
Effective date
Apr 1, 2025
We identified it
Jun 24, 2026
Days to comply

Summary

New Medicare Advantage coverage policy for Kebilidi (eladocagene exuparvovec-tneq), a gene therapy for AADC deficiency. This is a brand new policy establishing coverage criteria for this rare neurological condition treatment that requires specialized neurosurgical administration.

Action Required

Action needed
Before April 1, 2025: Billing team should add new codes to system for Kebilidi gene therapy (CPT 64999, HCPCS C9399/J3490/J3590, ICD-10 XW0Q316). All requests must be referred to Corporate Transplant Department at 1-866-421-5663 or transplant@humana.com. Ensure prior authorization process captures age requirements (16 months-64 years) and genetic confirmation of AADC deficiency.

Affected Billing Codes

64999
C9399
J3490
J3590