← Back to list
Gene Expression Profiling for Cancer Indications - MEDICAID - OHIO (New)
Effective date
Apr 13, 2026
Identified
Jun 24, 2026
Summary
New Ohio Medicaid policy establishes coverage for specific gene expression profiling tests for cancer, covering ConfirmMDx for prostate cancer management and DecisionDx-UM for uveal melanoma risk stratification, while explicitly excluding three other GEP tests due to insufficient evidence.
Get alerts when payers change rules like this one
We check Humana and other payers every day and email you when a change matches your specialty and state.
Get Humana alertsPolicy Monitoring is free. No card required.
What to do
Action · 4 steps
01Before April 13, 2026: Billing team must update prior authorization processes for Ohio Medicaid members requiring gene expression profiling tests.
02Ensure CPT 81551 (ConfirmMDx) and 81552 (DecisionDx-UM) meet specific clinical criteria before submission.
03Flag CPT 81529, 0047U, and 0090U as non-covered for Ohio Medicaid and inform providers these will be denied.
04Update billing system to reflect coverage limitations.
Codes mentioned
815518155281529
Original notice
Gene Expression Profiling for Cancer Indications - MEDICAID - OHIO (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)HighEffective Oct 14, 2026 · MedicaidGene 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 · MedicaidBrowse every Humana change in the policy list