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ACG

h.o.l.M.E.S.

Automated Clinical Guidelines

Cell & Gene Therapy

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Indicates Non-covered Service

ABECMA (idecabtagene vicleucel), ADSTILADRIN (nadofaragene firadenovec-vcng), ALLOCORD (HPC, Cord Blood), AMTAGVI (lifileucel), BEQVEZ (fidanacogene elaparvovec-dzkt), BREYANZI (lisocabtagene maraleucel), CARVYKTI (ciltacabtagene autoleucel), CASGEVY (exagamglogene autotemcel [exa-cel]), CLEVECORD (HPC Cord Blood), Ducord, HPC Cord Blood, ELEVIDYS (delandistrogene moxeparvovec-rokl), GINTUIT (Allogeneic Cultured Keratinocytes and Fibroblasts in Bovine Collagen), HEMACORD (HPC, cord blood), HEMGENIX (etranacogene dezaparvovec-drlb), HPC, Cord Blood - MD Anderson Cord Blood Bank, HPC, Cord Blood – LifeSouth HPC, Cord Blood – Bloodworks, IMLYGIC (talimogene laherparepvec), KYMRIAH (tisagenlecleucel), LANTIDRA (donislecel), LAVIV (Azficel-T), LENMELDY (atidarsagene autotemcel), LUXTURNA (voretigene neparvovec-rzyl), LYFGENIA (lovotibeglogene autotemcel [lovo-cel]), MACI (Autologous Cultured Chondrocytes on a Porcine Collagen Membrane), OMISIRGE (omidubicel-onlv), PROVENGE (sipuleucel-T), RETHYMIC (allogeneic processed thymus tissue – agdc), ROCTAVIAN (valoctocogene roxaparvovec-rvox), SKYSONA (elivaldogene autotemcel), STRATAGRAFT (allogeneic cultured keratinocytes and dermal fibroblasts in murine collagen-dsat), TECARTUS (brexucabtagene autoleucel), TECELRA (afamitresgene autoleucel), VYJUVEK (beremagene geperpavec), YESCARTA (axicabtagene ciloleucel), ZYNTEGLO (betibeglogene autotemcel), ZOLGENSMA (onasemnogene abeparvovec-xioi), car-t, cart

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