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Testosterone Enanthate Injection (CPB 1015, reviewed 2026-07-17)

Aetna·Endocrinology, OB-GYN, Pediatrics +4 more·Pharmacy
Effective date
Jul 17, 2026
We identified it
Aug 18, 2026
Days to comply

Summary

Aetna updated its Clinical Policy Bulletin 1015 for testosterone enanthate injection (intramuscular only), effective July 17, 2026. The policy covers four approved indications: hormone-responsive breast cancer, delayed puberty, gender dysphoria (including adolescents meeting specific criteria), and primary/hypogonadotropic hypogonadism. Billing teams must ensure prior authorization requirements are met for covered indications and verify medical necessity documentation, particularly for gender-affirming care and hypogonadism diagnoses.

Action Required

Action needed
By July 17, 2026: Billing team must update authorization protocols to require prior approval for CPT 96372, 99506, and HCPCS J3121 when billed with approved ICD-10 codes (breast cancer C50.x, E23.0, E29.1, E30.0, or F64.x series). For gender dysphoria claims (F64.0-F64.9), verify prescriber specialization documentation and mental health provider collaboration for members under 18. For hypogonadism claims (E23.0, E29.1), ensure claims include documentation of at least two confirmed low morning testosterone levels. Reject claims for experimental indications: age-related hypogonadism, female sexual dysfunction (F52.0, F52.22), heart failure (I50.1-I50.9), or cognitive decline (R41.81). Update EMR templates and claim submission workflows to include medical necessity checklist. Failure to verify these requirements will result in claim denials.

Affected Billing Codes

84402
84403
84410
96372
99506
J3121
C50.011
C50.012
C50.021
C50.022
C50.111
C50.112
C50.121
C50.122
C50.211
C50.212
C50.221
C50.222
C50.311
C50.312
C50.321
C50.322
C50.411
C50.412
C50.421
C50.422
C50.511
C50.512
C50.521
C50.522
C50.611
C50.612
C50.621
C50.622
C50.811
C50.812
C50.821
C50.822
C50.911
C50.912
C50.921
C50.922
C50.929
C50.A0
C50.A1
C50.A2
E23.0
E29.1
E30.0
F64.0
F64.1
F64.2
F64.8
F64.9