Medicare AdvantageCoverageMedium impact
Genetic Testing for Hematologic Malignancies and Suspected Myeloid Disorders - Medicare Advantage (Revised)
Humana·Hematology, Oncology, Pathology·Medicare Advantage
Effective date
Apr 1, 2026
We identified it
Jun 24, 2026
Summary
This is a new Medicare Advantage policy establishing coverage criteria for genetic testing for hematologic malignancies and suspected myeloid disorders, including comprehensive genomic profiling, multigene panels, and single gene testing. The policy provides detailed coverage determinations and limitations for various genetic testing methodologies used to diagnose and monitor blood cancers.
Action Required
Before April 1, 2026: Review and update billing procedures for genetic testing related to blood cancers and myeloid disorders for Medicare Advantage patients. Ensure compliance with applicable MAC LCD requirements based on practice location. Verify coverage criteria are met before ordering comprehensive genomic profiling, NGS panels, or single gene tests for hematologic malignancies.