CurrentCentenePolicy CP.MP.108

Allogeneic Hematopoietic Cell Transplants for Sickle Cell Anemia and β-thalassemia

Medical necessity criteria for allogeneic hematopoietic cell transplantation (AHCT) to treat sickle cell anemia and homozygous β-thalassemia for non-Medicare Centene-affiliated health plans; includes indications, absolute contraindications, and statements on insufficient evidence for certain transplants.

Policy Summary

PayerCentene

PolicyAllogeneic Hematopoietic Cell Transplants for Sickle Cell Anemia and β-thalassemia

Policy CodePolicy CP.MP.108

Change TypeRevised (criteria clarifications) + Informational additions

Effective Date

Next Review Date

Key ActionProvide documentation of donor HLA match and the qualifying indication, and document the planned myeloablative conditioning regimen where required.

SourceLink

POLICY UPDATE CHANGES

Removed age limit criteria from prior indications and removed first-degree relative donor requirement for cord blood source in homozygous β-thalassemia.

Added notes referencing related product-specific policies for Zynteglo and Casgevy and added reference to Medicare-specific policy MC.CP.MP.108.

3Primary indication groupings listed (sickle cell anemia, homozygous β-thalassemia, transfusion-dependence)

2Autologous HCT uses listed as insufficient evidence (sickle cell anemia, β-thalassemia) outside gene therapy

4Absolute contraindications listed

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.