MedicaidCoverageMedium impact
Expanded Coverage of Cancer Biomarkers for Companion Diagnostic Testing and Targeted Drug Therapies, Effective August 1, 2023
Maryland Medicaid·MD · Oncology, Pathology, Hematology·Provider Transmittal
Effective date
Aug 1, 2023
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has expanded coverage for cancer biomarkers used in companion diagnostic testing and targeted drug therapies, effective August 1, 2023. This change allows for broader billing opportunities for cancer-related diagnostic tests and personalized treatment approaches.
Action Required
Immediately: Billing team should review current cancer biomarker test denials from Maryland Medicaid and consider resubmitting claims for companion diagnostic testing and targeted drug therapies. Update billing procedures to include newly covered cancer biomarker services for Maryland Medicaid patients. Coordinate with oncology providers to identify eligible patients for expanded biomarker testing coverage.