MedicaidCoverageMedium impact
Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - MEDICAID - KENTUCKY (Revised)
Humana·KY · Transplant Surgery, Nephrology, Cardiology +2 more·Medicaid
Effective date
Nov 12, 2025
We identified it
Jun 24, 2026
Summary
Humana Kentucky Medicaid will not cover any molecular diagnostic assays or breath testing for transplant rejection effective November 12, 2025. All related testing including gene expression profiling, donor-derived cell-free DNA tests, and HLA testing for rejection monitoring are excluded from coverage.
Action Required
Before November 12, 2025: Billing team must update systems to deny all molecular diagnostic and breath testing claims for transplant rejection for Kentucky Medicaid members. Update prior authorization systems to automatically deny requests for codes 81378, 81379, 0001U, 0018M, 0055U, 0087U, 0088U, 0319U, and related unlisted codes. Notify providers that these tests are not covered and claims will be denied.