CommercialCoverageMedium impact
Measurable Residual Disease (MRD) Assessment Testing 2.02.54
Excellus BlueCross BlueShield·Oncology, Hematology, Pathology·Lab Tests (pathology)
Effective date
Dec 15, 2025
We identified it
Jun 20, 2026
Summary
New policy establishes coverage criteria for Measurable Residual Disease (MRD) testing effective December 15, 2025. ClonoSEQ Assay is approved for ALL, CLL, and Multiple Myeloma, while flow cytometry is covered for leukemia, lymphoma, and multiple myeloma. Multiple other MRD tests (Signatera, MyMRD, Guardant Reveal, etc.) are considered investigational and not covered.
Action Required
By December 15, 2025: Billing team must update prior authorization requirements to ensure ClonoSEQ Assay tests are only billed for FDA-approved indications (ALL, CLL, Multiple Myeloma) and flow cytometry for leukemia, lymphoma, and multiple myeloma. Update system to flag investigational MRD tests (Signatera, MyMRD, Guardant Reveal, Northstar Response, Invitae PCM, HPV-SEQ, M-insight, UroAmp) as non-covered. Train staff that concurrent MRD testing by multiple laboratory methods is not appropriate as duplicative testing.