MedicaidCoverageHigh impact
Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - MEDICAID - FLORIDA (Revised)
Humana·FL · Transplant Surgery, Nephrology, Cardiology +2 more·Medicaid
Effective date
Apr 6, 2026
We identified it
Jun 24, 2026
Summary
Humana Florida Medicaid has issued a comprehensive policy stating that molecular diagnostic assays and breath testing for transplant rejection are NOT covered. This includes gene expression profiling, donor-derived cell-free DNA tests, breath testing, HLA testing, and urine-based tests for allograft rejection.
Action Required
Before April 6, 2026: Billing team must update systems to flag all transplant rejection molecular diagnostic and breath testing codes as non-covered for Humana Florida Medicaid patients. Route all requests to Corporate Transplant Department at 1-866-421-5663 or transplant@humana.com. Update encounter forms to alert providers that these tests require alternative coverage sources. Claims submitted for these services will be denied.