TL;DR: Aetna, a CVS Health company, modified CPB 0495 governing hematopoietic cell transplantation for Hodgkin's disease, effective December 11, 2025. Here's what billing teams need to do.

This update to the Aetna hematopoietic cell transplantation coverage policy affects how you document and bill autologous and allogeneic transplants for Hodgkin's disease (HD) under CPT codes 38240 and 38241, among others. The policy sets specific medical necessity criteria that determine whether claims for harvesting (CPT 38205, 38206), bone marrow procurement (CPT 38230, 38232), transplant preparation (CPT 38210–38213), and HLA typing (CPT 86813, 86817, 86821) will be covered. If your transplant program bills Aetna for HD cases, review your documentation against CPB 0495 Aetna criteria before submitting claims dated on or after the effective date of December 11, 2025.


Quick-Reference Table

Field Detail
Payer Aetna, a CVS Health company
Policy Hematopoietic Cell Transplantation for Hodgkin's Disease
Policy Code CPB 0495
Change Type Modified
Effective Date December 11, 2025
Impact Level High
Specialties Affected Hematology/Oncology, Bone Marrow Transplant Programs, Radiation Oncology, Hematopathology
Key Action Confirm transplanting institution selection criteria are documented in the medical record before billing CPT 38240 or 38241 for any HD case

Aetna Hematopoietic Cell Transplantation Coverage Criteria and Medical Necessity Requirements 2025

The Aetna hematopoietic cell transplantation coverage policy under CPB 0495 takes a two-track approach to medical necessity. Track one: the transplanting institution has its own formal patient selection criteria. Track two: Aetna's own criteria apply when the institution doesn't have them.

This matters for your billing team because the documentation required differs depending on which track applies.

Autologous Transplantation (CPT 38241, 38206, 38232)

Aetna covers autologous hematopoietic cell transplantation for Hodgkin's disease when the member meets the transplanting institution's selection criteria. Full stop — if your institution has documented selection criteria and the patient qualifies, that's your primary path to coverage.

When the institution has no formal criteria, Aetna's own two-part test applies. The member must be in primary induction failure or beyond first remission. And the member must have no serious organ dysfunction, based on the transplanting institution's evaluation. Both conditions are required — not one or the other.

For billing purposes, this means your prior authorization submission and medical record need to explicitly address these two criteria when institutional criteria aren't in play. A vague note saying "patient failed first-line therapy" won't cut it. Document the specific remission status and organ function evaluation.

Allogeneic Transplantation (CPT 38240, 38205, 38230)

The allogeneic pathway covers a broader set of clinical scenarios. Aetna covers allogeneic transplantation for relapsed HD, persistent HD after a prior autologous transplant, and primary refractory HD — provided the member meets the transplanting institution's selection criteria.

Again, when institutional criteria are absent, both prongs of the medical necessity test must be met: primary induction failure or beyond first remission, plus no serious organ dysfunction.

Non-myeloablative allogeneic transplantation — sometimes called a "mini-transplant" or reduced intensity conditioning (RIC) transplant — gets its own specific coverage path. Aetna covers this for members with relapsed or primary refractory HD, including post-autologous failures, when the member is eligible for conventional allografting. Eligibility for conventional allografting is the determining factor here. If that's not clearly documented, expect a claim denial.

Prior authorization for allogeneic transplants is standard practice with Aetna on high-cost oncology procedures. Don't submit claims for CPT 38240 without confirming your PA is in place and specifically addresses the clinical scenario — relapsed, refractory, or post-autologous.

HLA Typing and Donor Search (CPT 38204, 86813, 86817, 86821)

Aetna considers HLA typing and donor management covered when the selection criteria are met. CPT 86813 (HLA typing, A, B or C, multiple antigens), CPT 86817 (DR/DQ, multiple antigens), and CPT 86821 (lymphocyte culture, mixed) are all in the covered group under this coverage policy.

CPT 38204 (management of recipient hematopoietic progenitor cell donor search and cell acquisition) is also covered when criteria are met. Allogeneic cases require donor sourcing — make sure this code is in your charge capture workflow for allo cases.

Transplant Preparation Codes (CPT 38210–38213)

Preparation procedures are covered when selection criteria are satisfied. This includes CPT 38210 (specific cell depletion with harvest, T-cell), 38211 (tumor cell depletion), 38212 (red blood cell removal), and 38213 (platelet depletion). Bill the specific preparation code that reflects what was actually performed — don't default to an unspecified code when a more specific one applies.


Aetna Hematopoietic Cell Transplantation Exclusions and Non-Covered Indications

There's one clear experimental designation in this policy, and it's a significant one for some transplant programs.

Tandem transplants — also called sequential transplants — are considered experimental, investigational, or unproven for Hodgkin's disease. Aetna's position is that the evidence doesn't support their effectiveness and safety for this indication. Don't submit claims for tandem transplant sequences in HD cases expecting coverage. You'll face denial.

This mirrors a broader pattern across payers: combination or sequential transplant strategies in hematologic malignancies are under scrutiny. The evidence bar for tandem approaches hasn't been cleared to Aetna's standard, at least not for HD.

If your program is considering a tandem protocol for an HD patient on an Aetna plan, loop in your compliance officer and billing consultant before scheduling — not after. The prior authorization process will make Aetna's position clear, but getting that answer before clinical planning begins saves everyone time.


Coverage Indications at a Glance

Indication Status Relevant Codes Notes
Autologous HCT — patient meets institutional selection criteria Covered CPT 38241, 38206, 38232 Institutional criteria must be documented
Autologous HCT — primary induction failure or beyond 1st remission, no serious organ dysfunction Covered CPT 38241, 38206, 38232 Both criteria required; applies when no institutional criteria exist
Allogeneic HCT — relapsed HD, meeting institutional selection criteria Covered CPT 38240, 38205, 38230 Includes post-autologous relapse or persistent disease
+ 6 more indications

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This policy is now in effect (since 2025-12-11). Verify your claims match the updated criteria above.

Aetna Hematopoietic Cell Transplantation Billing Guidelines and Action Items 2025

#Action Item
1

Audit your documentation templates against CPB 0495 before December 11, 2025. Every HD transplant case needs explicit documentation of either institutional selection criteria or both Aetna fallback criteria. The organ dysfunction evaluation is a common gap — make sure the transplanting institution's assessment is in the record, not just implied by the plan of care.

2

Confirm prior authorization is in place for all allogeneic transplant cases. CPT 38240 without PA on an Aetna plan is a fast path to denial. Your PA request should specify the clinical scenario — relapsed, refractory, or post-autologous — because each has a different coverage path under this policy.

3

Flag any tandem transplant cases on Aetna plans immediately. If you have HD patients on Aetna who are being considered for sequential transplant protocols, escalate to your compliance officer now. Billing for tandem transplants will result in denial, and retroactive appeals on experimental designations are difficult.

+ 4 more action items

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If your program handles a high volume of Aetna HD cases, have your compliance officer review your current PA workflow against the updated criteria in CPB 0495 before the effective date. The two-track selection criteria framework — institutional criteria versus Aetna's fallback — creates real documentation variability across cases. Your team needs a consistent process for identifying which track applies.


Sample Version Diff Line-by-line changes
Previous VersionCurrent Version
Coverage is considered experimental and investigational for all indicationsCoverage is considered medically necessary when specific criteria are met
Prior authorization is not requiredPrior authorization is required for initial treatment
Documentation must include clinical historyDocumentation must include clinical history
+ 1 more action items

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CPT, HCPCS, and ICD-10 Codes for Hematopoietic Cell Transplantation Under CPB 0495

Covered CPT Codes (When Selection Criteria Are Met)

Code Type Description
38204 CPT Management of recipient hematopoietic progenitor cell donor search and cell acquisition
38205 CPT Blood-derived hematopoietic progenitor cell harvesting for transplantation — allogeneic
38206 CPT Blood-derived hematopoietic progenitor cell harvesting for transplantation — autologous
+ 11 more codes

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