MedicaidCoverageMedium impact
Molecular Biomarker Testing for Noncancer Indications - MEDICAID - KENTUCKY (New)
Humana·KY · Cardiology, OB-GYN, Genetics +5 more·Medicaid
Effective date
May 6, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid in Kentucky has established a new policy (HUM-2253-000) covering molecular biomarker testing for non-cancer conditions, including cardiovascular disease markers, genetic testing, prenatal screening, and various gene expression profiling tests. The policy defines coverage criteria and limitations for these specialized diagnostic tests effective May 6, 2025.
Action Required
Before May 6, 2025: Billing team must review the complete policy document to identify specific CPT/HCPCS codes and coverage limitations for molecular biomarker testing. Update billing system with coverage criteria for Kentucky Medicaid members requiring genetic testing, prenatal screening, or gene expression profiling. Train staff on documentation requirements for these specialized tests to ensure proper claim submission.