MedicaidCoverageMedium impact
Genomic and Molecular Biomarker Testing for Cancer - MEDICAID - VIRGINIA (Revised)
Humana·VA · Oncology, Genetics·Medicaid
Effective date
May 27, 2026
We identified it
Jun 24, 2026
Summary
Humana Virginia Medicaid has updated their policy to explicitly state that concurrent DNA/RNA genetic testing for cancer (including +RNAinsight tests) are NOT covered services. The policy lists specific CPT codes that will not be reimbursed due to insufficient evidence.
Action Required
By May 27, 2026: Billing team must update system to flag CPT codes 0133U, 0157U, 0159U, 0160U, 0161U, and 0162U as non-covered for Virginia Medicaid patients. Update encounter forms to alert providers that concurrent DNA/RNA genetic testing (+RNAinsight tests) are not covered by Humana Virginia Medicaid. Claims submitted with these codes will be denied.