Traditional MedicareCoverageHigh impact
Chimeric Antigen Receptor (CAR) T-cell Therapy
Medicare/CMS - NCD·Oncology, Hematology·National Coverage Determination
Effective date
Aug 19, 2026
We identified it
Aug 20, 2026
Summary
CMS has issued a new National Coverage Determination (NCD 110.24) for Chimeric Antigen Receptor (CAR) T-cell Therapy effective 8/19/2026. This policy establishes Medicare coverage parameters, medical necessity criteria, and billing requirements for CAR T-cell therapies. Billing teams must immediately review the full policy text to identify coverage conditions, prior authorization requirements, and applicable billing codes to ensure compliant claims submission.
Action Required
By 8/19/2026: Billing team must obtain and review the complete NCD 110.24 policy text from the CMS Medicare Coverage Database. Identify all covered indications, medical necessity documentation requirements, and any prior authorization mandates. Update billing system to enforce coverage rules and implement required prior authorization workflows. Providers must document medical necessity per NCD criteria on all CAR T-cell therapy claims. Train front-desk and billing staff on new requirements. Claims submitted without proper documentation or authorization will be denied by Medicare.