Medicare AdvantageCoverageMedium impact
Hematopoietic Stem Cell Transplantation - Medicare Advantage (Revised)
Humana·Hematology, Oncology, Transplant Surgery·Medicare Advantage
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
This is a revised Medicare Advantage policy for Hematopoietic Stem Cell Transplantation that provides updated coverage determinations and geographic jurisdictional guidance for various transplant procedures including autologous and allogeneic stem cell transplants.
Action Required
Before December 1, 2025: Review current stem cell transplant billing procedures to ensure compliance with updated coverage determinations. Verify correct Local Coverage Determination (LCD) numbers for your MAC jurisdiction when billing allogeneic transplants for Hodgkin and Non-Hodgkin lymphoma. Update prior authorization processes to reference the correct LCD based on geographic location.