← Back to list
Gene Expression Profiling for Cancer Indications - MEDICAID - VIRGINIA (Revised)
Effective date
Apr 8, 2026
Identified
Jun 24, 2026
Summary
Humana Medicaid in Virginia has updated coverage policies for gene expression profiling tests for cancer. ConfirmMDx (81551) is covered for specific prostate cancer indications, while multiple other gene expression tests including bladder cancer, lymphoma, and other cancer screening tests are explicitly non-covered.
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 · 2 steps
01Before April 8, 2026: Billing team must update prior authorization systems to allow ConfirmMDx (81551) for Virginia Medicaid members with specific prostate cancer indications (atypia suspicious for cancer, benign but clinical suspicion persists, or high-grade PIN).
02Update billing software to flag and deny the 24 non-covered gene expression profiling codes listed in the policy for Virginia Medicaid claims to prevent claim denials.
Codes mentioned
8155181540
Original notice
Gene Expression Profiling for Cancer Indications - MEDICAID - VIRGINIA (Revised)
mcp.humana.com · Always check the source before changing claims.
Related changes
See all Humana changes →Gene 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 - INDIANA (New)MediumEffective Jun 3, 2025 · MedicaidGene Expression Profiling for Cancer Indications - MEDICAID - FLORIDA (New)MediumEffective Jun 3, 2025 · MedicaidBrowse every Humana change in the policy list