Genetic Testing for Alzheimer Disease
Summary
Since the 06/15/2025 policy update, genetic testing for the APOE gene is considered medically necessary to guide initiation or management of an FDA-approved amyloid-beta targeting therapy in individuals with mild cognitive impairment or mild dementia associated with Alzheimer disease, where it was previously investigational. Genetic testing for the risk assessment of Alzheimer disease in asymptomatic individuals is considered investigational in all other situations. Targeted testing for a known familial variant in the PSEN or APP genes may be considered medically necessary in an asymptomatic individual when a first- or second-degree relative has a known familial variant and the results will inform reproductive decision making.
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