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AetnaCommercial · Coverage · Medical Policy · Oncology, HematologyMedium impact

Aldesleukin (Proleukin) (CPB 0024, reviewed 2026-10-09)

Effective date
Not stated in the notice
Identified
Oct 12, 2026

Summary

Aetna's Clinical Policy Bulletin 0024 covers intravenous aldesleukin (Proleukin) for commercial medical plans and considers it medically necessary for unresectable or metastatic cutaneous melanoma, chronic graft-versus-host disease, neuroblastoma and metastatic renal cell carcinoma. Continuation of therapy for renal cell carcinoma or single-agent subsequent treatment of melanoma requires a response evaluation about 4 weeks after each course and again before the next course, further courses only when there is some tumor shrinkage after the last course, no contraindication to retreatment, and a rest period of at least 7 weeks from hospital discharge between courses. Aetna considers all other indications experimental, investigational, or unproven, and considers subcutaneous IL-2 experimental for renal cell carcinoma and all other indications except intralesional administration of IL-2 for melanoma.

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What to do

Action · 5 steps
01Billing team: bill aldesleukin as medically necessary only for the indications the policy lists as covered (metastatic renal cell carcinoma, unresectable or metastatic cutaneous melanoma, chronic graft-versus-host disease and neuroblastoma), and treat all other indications as experimental, investigational or unproven.
02Billing team: for continued therapy, confirm a response evaluation about 4 weeks after completion of a course and again immediately before the next course, and confirm a rest period of at least 7 weeks from the date of hospital discharge between courses.
03Billing team: intravenous aldesleukin is given in a hospital setting under the supervision of a qualified physician experienced in anticancer agents, and if hospitalization is required, it is not medically necessary for the initial length of stay to exceed the number of days of IL-2 administration, typically 5 days or less.
04Billing team: therapy is to be restricted to patients with normal cardiac and pulmonary functions as defined by thallium stress testing and formal pulmonary function testing.
05Billing team: subcutaneous IL-2 is experimental for renal cell carcinoma and for all indications other than intralesional administration for melanoma.

Codes mentioned

J9015J0480J75139637996405964069640996411C30.0D89.811D89.812

Original notice

Aldesleukin (Proleukin) (CPB 0024, reviewed 2026-10-09)
aetna.com · Always check the source before changing claims.
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Related policy hubs

Aetna policiesOncologyHematologyCode J9015Code J0480Code J7513Code 96379Code 96405Code 96406Code 96409Code 96411Code C30.0Code D89.811Code D89.812

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