All PlansCoverageMedium impact
Genetic Testing Medical Policies Avalon
HMSA·Oncology, OB-GYN, Cardiology +5 more·Medical Policy
We identified it
Jun 20, 2026
Summary
HMSA has updated their genetic testing medical policies through Avalon. This fresh policy change affects coverage criteria, prior authorization requirements, or billing guidelines for genetic testing procedures and may impact how genetic tests are billed and reimbursed.
Action Required
Immediately: Review the updated HMSA genetic testing policies at https://prc.hmsa.com/s/article/Genetic-Testing-Medical-Policies-Avalon. Billing team should verify current prior authorization requirements, coverage criteria, and billing guidelines for all genetic testing services. Update internal protocols and inform providers of any changes to ensure compliant billing practices.