MedicaidCoverageMedium impact
Molecular Biomarker Testing for Noncancer Indications - MEDICAID - SOUTH CAROLINA (New)
Humana·SC · Cardiology, Nephrology, Genetics +5 more·Medicaid
Effective date
May 6, 2025
We identified it
Jun 24, 2026
Summary
Humana South Carolina Medicaid has established a new policy (HUM-2253-000) covering molecular biomarker testing for noncancer conditions, including cardiovascular disease, kidney disease, genetic disorders, prenatal screening, gene expression profiling, and multianalyte assays. This policy defines coverage parameters and limitations for these specialized diagnostic tests.
Action Required
By May 6, 2025: Billing team must review the complete policy HUM-2253-000 to understand coverage criteria for molecular biomarker tests including ST2 cardiovascular markers, APOL1 kidney disease testing, MTHFR gene variants, prenatal screening panels, gene expression profiling, and multianalyte assays. Update prior authorization workflows and documentation requirements for South Carolina Medicaid members requiring these specialized tests.