MedicaidCoverageHigh impact
Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - MEDICAID - MICHIGAN (New)
Humana·MI · Transplant Surgery, Nephrology, Cardiology +2 more·Medicaid
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Michigan has established a new policy effective January 1, 2025, that explicitly denies coverage for all molecular diagnostic assays and breath testing for transplant rejection. All related test requests must now be referred to Humana's Corporate Transplant Department for review.
Action Required
Immediately: Billing team must update system to flag all molecular diagnostic assays and breath testing codes for transplant rejection as non-covered for Humana Medicaid Michigan members. Establish workflow to refer all requests to Corporate Transplant Department at 1-866-421-5663 or transplant@humana.com before billing. Train staff that these services will be denied and require pre-referral to transplant department.