MedicaidCoverageMedium impact
Genomic and Molecular Biomarker Testing for Cancer - MEDICAID - FLORIDA (New)
Humana·FL · Hematology, Oncology, Pathology·Medicaid
Effective date
Jan 16, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Florida has implemented a new policy covering genomic and molecular biomarker testing for cancer, including comprehensive genomic profiling and multigene panel testing for hematologic malignancies and suspected myeloid disorders. The policy establishes specific coverage criteria for conditions like AML, MDS, myeloproliferative neoplasms, and systemic mastocytosis.
Action Required
Before January 16, 2026: Billing team must update systems to recognize new Humana Medicaid Florida coverage for genomic testing using CPT codes 81450 and 81455. Ensure documentation supports covered indications including AML, MDS, myeloproliferative neoplasms, undefined cytopenia >4 months, or systemic mastocytosis. Update encounter forms and EMR templates to capture required clinical criteria.