Medical and Pharmacy Coverage Policies

Effective Date	Policy Name	Reviewed Date
9/1/2026	Radiofrequency Tumor Ablation - Medicare Advantage	8/11/2026
2/16/2024	Rapid Whole Genome Sequencing (rWGS) of Critically Ill Infants - MEDICAID - LOUISIANA	10/10/2024
5/20/2026	RECELL Autologous Cell Harvesting Device - MEDICAID - INDIANA	2/3/2026
8/12/2026	RECELL Autologous Cell Harvesting Device - MEDICAID - KENTUCKY	2/3/2026
5/27/2026	RECELL Autologous Cell Harvesting Device - MEDICAID - VIRGINIA	2/3/2026
2/2/2026	RECELL Autologous Cell Harvesting Device - Medicare Advantage	1/13/2026
10/1/2025	Rethymic (allogenic processed thymus tissue - agdc) - Medicare Advantage	9/9/2025
10/1/2025	Rheumatoid Arthritis: Biologic Markers and Pharmacologic Assessment - Medicare Advantage	9/9/2025
5/1/2026	Ryoncil (remestemcel-L-rknd) - Medicare Advantage	4/14/2026

Medical Coverage Policies