CommercialCoverageMedium impact
Chromosomal Microarray (CMA) Analysis for Prenatal Evaluation and Evaluation of Patients with Developmental Delay/ Intellectual Disability or Autism Spectrum Disorder 2.02.42
Excellus BlueCross BlueShield·OB-GYN, Pediatrics, Neurology +1 more·Genetic Disease (Inherited Disease)
Effective date
Nov 20, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has updated their policy for Chromosomal Microarray (CMA) Analysis, effective November 20, 2025. The policy establishes specific medical necessity criteria for CMA testing in children with developmental delays, intellectual disabilities, autism spectrum disorders, and for prenatal diagnostic testing, requiring genetic counseling and qualified laboratory testing.
Action Required
By November 20, 2025: Billing team must update prior authorization requirements for CMA testing to ensure genetic counseling documentation is obtained before testing, verify laboratory CLIA certification, and confirm metabolic testing has been performed for pediatric cases. Update encounter forms to remind providers of new medical necessity criteria. Claims may be denied without proper documentation of genetic counseling and clinical criteria.