MedicaidCoverageMedium impact
Molecular Biomarker Testing for Noncancer Indications - MEDICAID - FLORIDA (New)
Humana·FL · Cardiology, Genetics, Nephrology +6 more·Medicaid
Effective date
Jun 13, 2025
We identified it
Jun 24, 2026
Summary
Humana Florida Medicaid has implemented a new policy defining coverage for molecular biomarker testing for non-cancer conditions, including cardiovascular disease markers, genetic testing, gene expression profiling, and multi-analyte assays. This policy establishes coverage guidelines for various specialized genetic and biomarker tests that may be used for screening, diagnosis, and treatment decisions across multiple medical conditions.
Action Required
Before June 13, 2025: Billing team must review the new Humana Florida Medicaid policy HUM-2253-000 for molecular biomarker testing coverage limitations and coding requirements. Update billing procedures to ensure proper documentation and medical necessity requirements are met for genetic testing, gene expression profiling, and multi-analyte assays for non-cancer conditions. Verify coverage determination criteria before submitting claims for these specialized tests.