CommercialCoverageMedium impact
Gene Expression Profile Testing and Circulating Tumor DNA Testing for Predicting Recurrence in Colon Cancer (2.04.61)
Blue Shield of California·CA · Oncology, Gastroenterology, General Surgery·Medical Policy
Effective date
Nov 1, 2025
We identified it
Nov 1, 2025
Summary
Blue Shield of California policy declares gene expression profile testing and circulating tumor DNA testing for predicting colon cancer recurrence as investigational (not covered) for stage II or III colon cancer patients. California biomarker testing laws may override this policy in some cases.
Action Required
Before November 1, 2025: Billing team must update system to flag gene expression profile and circulating tumor DNA tests for stage II/III colon cancer as investigational/non-covered for Blue Shield of California members. Review California biomarker testing law requirements for potential coverage exceptions. Train staff to identify affected tests including GeneFx Colon, Oncotype DX Colon Recurrence Score, and Colvera ctDNA test.