CommercialCoverageMedium impact
Molecular Testing in the Management of Pulmonary Nodules (2.04.142)
Blue Shield of California·CA · Pulmonology, Oncology, Radiology +1 more·Medical Policy
Effective date
Nov 1, 2025
We identified it
Nov 1, 2025
Summary
Blue Shield of California updated their policy on molecular testing for pulmonary nodules, classifying plasma-based proteomic screening tests (Nodify XL2, Nodify CDT, REVEAL) and gene expression profiling tests (Percepta) as investigational and not covered. This policy becomes effective November 1, 2025.
Action Required
Before November 1, 2025: Billing team must update system to flag molecular testing for pulmonary nodules (Nodify XL2, Nodify CDT, REVEAL, Percepta GSC) as non-covered/investigational for Blue Shield of California patients. Update encounter forms to alert providers these tests are considered investigational. Claims for these tests will likely be denied as investigational services.