Medicare AdvantageCoverageMedium impact
Genetic and Biomarker Testing for Neurodegenerative Disease - Medicare Advantage (Revised)
Humana·Neurology, Genetics, Geriatrics +2 more·Medicare Advantage
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has established new coverage criteria for genetic and biomarker testing for neurodegenerative diseases including Alzheimer's and Parkinson's. The policy requires tests to meet analytical and clinical validity standards through CMS guidance, MolDX approval, or FDA clearance within labeling indications.
Action Required
Before June 1, 2026: Review current genetic and biomarker testing orders for neurodegenerative diseases to ensure they meet new coverage criteria. Verify tests have MolDX approval, FDA clearance within labeling indications, or are covered under applicable LCD/LCA. Update prior authorization processes to check for analytical validity, clinical validity, and clinical utility documentation. Train providers on new requirements for CSF, plasma, and genetic testing related to Alzheimer's, Parkinson's, and other neurodegenerative conditions.