CommercialCoverageLow impact
Use of Common Genetic Variants (Single Nucleotide Variants) to Predict Risk of Nonfamilial Breast Cancer (2.04.63)
Blue Shield of California·CA · Genetics, Oncology, OB-GYN +2 more·Genetic Testing
Effective date
Dec 1, 2025
We identified it
Nov 1, 2025
Summary
Blue Shield of California updated its policy on genetic testing for breast cancer risk prediction using single nucleotide variants (SNVs), maintaining that such testing remains investigational and non-covered. The GeneType breast cancer risk test specifically continues to be considered investigational for all indications.
Action Required
By December 1, 2025: Billing team should verify that claims for SNV-based breast cancer risk prediction tests (including GeneType) are not being submitted to Blue Shield of California, as these services remain investigational and non-covered. Review any pending claims for genetic testing to ensure they relate to covered hereditary breast/ovarian cancer syndrome testing (BRCA1, BRCA2, PALB2) rather than SNV risk prediction.