Medicare AdvantageCoverageMedium impact
Minimal Residual Disease Testing - Medicare Advantage (Revised)
Humana·Oncology, Hematology·Medicare Advantage
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has revised its Medicare Advantage policy for Minimal Residual Disease (MRD) testing for cancer, effective June 1, 2026. The policy establishes coverage criteria for MRD tests used to measure cancer cells in blood for risk stratification and treatment monitoring in both solid tumors and hematologic malignancies.
Action Required
By June 1, 2026: Review and understand coverage criteria for MRD testing orders. Ensure proper documentation of medical necessity when ordering MRD tests like Guardant Reveal, Signatera, or ClonoSEQ. Verify test orders come from treating physicians and results will be used for patient management. Monitor for specific billing codes and prior authorization requirements as policy implementation approaches.