MedicaidCoverageMedium impact
Pharmacogenomics Testing - MEDICAID - INDIANA (New)
Humana·IN · Psychiatry, Oncology, Pharmacy +3 more·Medicaid
Effective date
Apr 8, 2026
We identified it
Jun 24, 2026
Summary
Humana Indiana Medicaid has established a new comprehensive pharmacogenomics testing policy effective April 8, 2026, specifying which genetic tests are covered versus not covered. The policy covers specific tests like DPYD, GeneSight Psychotropic, NUDT15/TPMT, SLCO1B1, and TYMS genotype testing under defined clinical criteria, while explicitly excluding many comprehensive panels and other pharmacogenomic tests.
Action Required
Before April 8, 2026: Billing team must update system to identify covered pharmacogenomic tests (DPYD 81232, GeneSight 0345U, IDgenetix 0411U, NUDT15 81306, TPMT 84433, SLCO1B1 81328, TYMS 81346) and flag non-covered tests for Indiana Medicaid members. Update prior authorization workflows to verify clinical criteria are met for covered tests. Configure system to reject claims for explicitly excluded comprehensive panels and other non-covered pharmacogenomic tests to prevent denials.