Traditional MedicareCoverageMedium impact
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer
Medicare/CMS - LCD·Oncology, Urology, Pathology·Local Coverage Determination
Effective date
Apr 16, 2026
We identified it
Jun 17, 2026
Summary
New local coverage determination L38684 establishes coverage criteria for prognostic and predictive molecular classifiers used in bladder cancer diagnosis and treatment. This policy defines when these specialized laboratory tests will be covered by Medicare.
Action Required
By April 16, 2026: Billing team must review coverage criteria for bladder cancer molecular classifier tests and ensure proper documentation requirements are met before submitting claims. Oncology providers should verify test orders meet the new LCD requirements to avoid claim denials.