CommercialPrior AuthHigh impact
Take Action Before Ordering Genetic Tests. See Details on the Genetic Testing Prior Authorization Program
CareFirst BlueCross BlueShield·OB-GYN, Oncology, Cardiology +4 more·Prior Authorization
Effective date
Feb 1, 2019
We identified it
Jun 20, 2026
Summary
CareFirst now requires prior authorization for all molecular genetic testing including reproductive screening, prenatal testing, hereditary cancer testing, and other genetic tests effective February 1, 2019. Providers must obtain authorization through the CareFirst Provider Portal before ordering these tests.
Action Required
Immediately: All providers and billing staff must obtain prior authorization through the CareFirst Provider Portal before ordering any molecular genetic tests including reproductive carrier screening, prenatal testing, rare disease testing, whole exome sequencing, genome sequencing, hereditary cancer testing, tumor markers categorized as genetic tests, hereditary cardiac testing, neurogenetic and neuromuscular testing, pharmacogenomics and thrombophilia testing, and susceptibility testing for common diseases. Navigate to Prior Auth/Notifications tab and use Add New Auth dropdown. Claims for genetic tests without prior authorization will be denied.