Billing and Coding: Sex Reassignment Services for Sexual Identity Dysphoria
National · Effective Jan 12, 2026
1 active Medicare policy lists 54125, and 8 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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National · Effective Jan 12, 2026
8 policies from 7 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 54125 |
|---|---|---|
| Cigna Commercial Other Services Code List - Effective 03/07/2026 | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List - Effective 03/07/2026 | Mar 7, 2026 | Prior auth required |
| Policy | Effective | Status of 54125 |
|---|---|---|
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 54125 |
|---|
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
|---|
| Policy | Effective | Status of 54125 |
|---|---|---|
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 54125 |
|---|---|---|
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 54125 |
|---|---|---|
| Gender Affirmation Surgery | Sep 1, 2026 | Covered |
| Policy | Effective | Status of 54125 |
|---|---|---|
| Gender Affirming Interventions for Gender Dysphoria | Apr 1, 2026 | Covered |