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Benefit and Prior Authorization Criteria for Eladocagene Exuparvovec-tneq (Kebilidi)

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Effective for dates of service on or after July 1, 2026, eladocagene exuparvovec-tneq (Kebilidi) is a benefit of Texas Medicaid when it is submitted on a claim with procedure code J3590. Prior authorization will be required beginning September 1, 2026.

Eladocagene exuparvovec-tneq (Kebilidi) (procedure code J3590) is an adeno-associated virus (AAV) vector-based gene therapy indicated to treat adult and pediatric clients with aromatic L-amino acid decarboxylase (AADC) deficiency.

Eladocagene exuparvovec-tneq (Kebilidi) is limited to one infusion per lifetime.

Prior Authorization Requirements

Providers must submit prior authorization requests for eladocagene exuparvovec-tneq (Kebilidi) on a Special Medical Prior Authorization (SMPA) Request Form.

The Texas Medicaid & Healthcare Partnership (TMHP) may approve prior authorization for eladocageneexuparvovec-tneq (Kebilidi) single-dose intraputaminal infusion for clients who meet the following requirements:

  • The client is 16 months of age or older.
  • The client has a confirmed diagnosis of AADC deficiency (diagnosis code E7081).
  • The client has biallelic mutations in the dopa decarboxylase (DDC) gene.
  • There is documentation of skull assessment confirming that the client has achieved skull maturity by neuroimaging, which is necessary for stereotactic neurosurgical administration of eladocageneexuparvovec-tneq (Kebilidi) therapy.
  • The client has not previously received eladocageneexuparvovec-tneq (Kebilidi) infusion for AADC deficiency.

Required Monitoring Parameters

After eladocageneexuparvovec-tneq (Kebilidi) infusion, providers must monitor the client for the following:

  • Post-procedural complications, which may include events of respiratory and cardiac arrest after administration
  • Additional procedure-related adverse events, such as cerebrospinal fluid leak, intracranial bleeding, neuroinflammation, acute infarction, and infection
  • Signs of dyskinesia or involuntary movements of the face, arm, leg, or entire body (fidgeting, writhing, wriggling, head bobbing, or body swaying) after administration

For more information, call the TMHP Contact Center at 800-925-9126.

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.