Medicare AdvantageCoverageLow impact
Rethymic (allogenic processed thymus tissue - agdc) - Medicare Advantage (Revised)
Humana·Pediatrics, Allergy & Immunology, Transplant Surgery·Pharmacy
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has established new coverage policy for Rethymic (allogeneic processed thymus tissue) for treating congenital athymia in patients 17 years or younger. All requests must be referred to Humana's Corporate Transplant Department for medical director review, with specific medical necessity criteria including confirmed congenital athymia diagnosis and absence of contraindications.
Action Required
By October 1, 2025: For any Rethymic (allogeneic processed thymus tissue) requests, billing team must contact Humana Corporate Transplant Department at 1-866-421-5663 or transplant@humana.com for prior authorization. Verify patient meets criteria: age 17 or under, confirmed congenital athymia diagnosis, no contraindications. Use CPT 60699 or HCPCS J3590 for billing. This affects extremely rare cases only.