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Multiplex Pathogen Identification Panels for Infectious Disease - Medicare Advantage (Revised)
Effective date
Nov 3, 2025
Identified
Jun 24, 2026
Replaced. This version was replaced by Multiplex Pathogen Identification Panels for Infectious Disease - Medicare Advantage (Revised) (effective Nov 2, 2026).
Summary
Humana Medicare Advantage has revised its policy for multiplex pathogen identification panels for infectious disease testing, effective November 3, 2025. The policy outlines coverage determination requirements that follow Medicare guidelines and requires medical necessity criteria to be met for molecular diagnostic tests and laboratory-developed tests.
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What to do
Action · 3 steps
01Before November 3, 2025: Billing team must review current multiplex pathogen identification panel billing practices for Humana Medicare Advantage members.
02Ensure all molecular diagnostic tests (MDTs) and laboratory-developed tests (LDTs) for infectious disease meet the medical necessity criteria outlined in applicable Local Coverage Determinations (LCDs) for your geographic jurisdiction.
03Update billing procedures to verify coverage requirements based on your Medicare Administrative Contractor's jurisdiction before submitting claims.
Original notice
Multiplex Pathogen Identification Panels for Infectious Disease - Medicare Advantage (Revised)
mcp.humana.com · Always check the source before changing claims.