`M0075` Cellular therapy

Cellular therapy

Medicare coverage: Non-covered by Medicare
Status: active (October 2026 file)

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 0 units per day (clinical), rationale: CMS Policy
Outpatient hospital: max 0 units per day (clinical), rationale: CMS Policy

Medicare pricing for M0075

Physician Fee Schedule (CY 2026, RVU26D)

Status N: non-covered service.

Payer policies and prior authorization for M0075

Payer coverage policies that name M0075

M0075 appears in 5 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Capital Blue Cross.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Adoptive Immunotherapy and Cellular Therapy (0641)	not covered	Sep 25, 2026	payer document
Aetna	Complementary and Alternative Medicine (0388)	not covered	Jun 25, 2026	payer document
Aetna	Hematopoietic Cell Transplantation for Selected Childhood Solid Tumors (0496)	not covered	Aug 6, 2026	payer document
Blue Cross & Blue Shield of Mississippi	Progenitor Cell Therapy For The Treatment Of Damaged Myocardium Due To Ischemia (L.2.02.413)	unproven / investigational		payer document
Capital Blue Cross	Experimental and Investigational Procedures (MP 4.002) Procedure codes: Miscellaneous	listed, no stance	Sep 1, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

ND: $0.00 (physician), effective Aug 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.

M0075 Cellular therapy