Treatment of Males with Low Testosterone
JE · Effective Jul 12, 2016
6 active Medicare policies list 11980, and 13 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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JE · Effective Jul 12, 2016
JF · Effective Jul 12, 2016
JJ · Effective Feb 13, 2022
JM · Effective Feb 13, 2022
National · Effective Oct 16, 2025
National · Effective Oct 1, 2026
13 policies from 9 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 11980 |
|---|---|---|
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Hormone Replacement Therapies | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 11980 |
|---|---|---|
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Hormone Replacement Therapies | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 11980 |
|---|---|---|
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Hormone Replacement Therapies | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 11980 |
|---|---|---|
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Hormone Replacement Therapies | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 11980 |
|---|---|---|
| Implantable Hormone Pellets | Jul 14, 2023 | Covered |
| Policy | Effective | Status of 11980 |
|---|---|---|
| Testosterone Replacement or Supplementation Therapy | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 11980 |
|---|---|---|
| Testosterone Replacement or Supplementation Therapy | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 11980 |
|---|---|---|
| Testosterone Replacement or Supplementation Therapy | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 11980 |
|---|---|---|
| Medications/Drugs (Outpatient/Part B) | Not recorded | Covered |