Coverage Guideline update — June 1, 2025

Effective June 1, 2025, Anthem Blue Cross and Blue Shield and its affiliate HealthKeepers, Inc. will implement the following new Coverage Guideline. This guideline was among those approved at the Medical Policy and Technology Assessment Committee meeting held on November 14, 2024.

Note:

• HealthKeepers, Inc. requires preapproval for the services addressed in the Coverage Guideline below.
• This guideline impacts all our products except Anthem HealthKeepers Plus, Medicare Advantage, and the Blue Cross and Blue Shield Service Benefit Plan (also called the Federal Employee Program^® or FEP^®).
• Pre‑determination can be requested for our Anthem PPO products.

The guideline addressed in this edition of Provider News is:

• MED.000151 Gene Therapy for Aromatic L-Amino Acid Decarboxylase Deficiency

Gene therapy for aromatic l-amino acid decarboxylase deficiency (MED.000151)

This new guideline addresses gene therapy for aromatic l-amino acid decarboxylase deficiency using eladocagene exuparvovec (Kebilidi). Gene therapy for aromatic l-amino acid decarboxylase deficiency using eladocagene exuparvovec is considered investigational and not medically necessary for all indications. The CPT^® and HCPCS codes associated with this new coverage guideline are 64999, C9399, J3490, and J3590.

This coverage guideline is available for review at Anthem.com.