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Gene Expression Profiling for Cancer Indications - MEDICAID - INDIANA (New)
Effective date
Jun 3, 2025
Identified
Jun 24, 2026
Summary
Humana Indiana Medicaid has established a new policy for gene expression profiling cancer tests, covering only ConfirmMDx (81551) for specific prostate cancer indications while excluding numerous other GEP tests including bladder, breast, and other cancer screenings due to insufficient evidence.
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What to do
Action · 3 steps
01Before June 3, 2025: Billing team must update system to only allow CPT 81551 (ConfirmMDx) for Indiana Medicaid members with prostate cancer atypia, benign with clinical suspicion, or high-grade PIN.
02Block all other listed GEP test codes for this payer as they are not covered.
03Update encounter forms to alert providers of coverage restrictions for gene expression profiling tests.
Codes mentioned
8155181540
Original notice
Gene Expression Profiling for Cancer Indications - MEDICAID - INDIANA (New)
mcp.humana.com · Always check the source before changing claims.
Related changes
See all Humana changes →Gene Expression Profiling for Cancer Indications - MEDICAID - VIRGINIA (Revised)MediumEffective Apr 8, 2026 · MedicaidGene Expression Profiling for Cancer Indications - MEDICAID - SOUTH CAROLINA (Revised)MediumEffective Apr 8, 2026 · MedicaidGene Expression Profiling for Cancer Indications - MEDICAID - MICHIGAN (New)MediumEffective Apr 8, 2026 · MedicaidGene Expression Profiling for Cancer Indications - MEDICAID - FLORIDA (New)MediumEffective Jun 3, 2025 · MedicaidBrowse every Humana change in the policy list