Traditional MedicareCoverageMedium impact
MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules
Medicare/CMS - LCD·Endocrinology, General Surgery, ENT (Ear, Nose & Throat) +2 more·Local Coverage Determination
Effective date
May 28, 2026
We identified it
Jun 17, 2026
Summary
This is a new Local Coverage Determination for molecular testing to risk stratify thyroid nodules, effective May 28, 2026. The policy establishes Medicare coverage criteria for genetic tests used to determine cancer risk in thyroid nodules found during imaging or examination.
Action Required
By May 28, 2026: Review complete policy text at https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39650&ver=7 to identify specific CPT codes, coverage criteria, and documentation requirements for thyroid nodule molecular testing. Update billing procedures and prior authorization workflows for affected molecular diagnostic tests. Train clinical staff on new coverage requirements.