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
Medicare has established a new Local Coverage Determination for molecular classifiers used to test bladder cancer, defining when these prognostic and predictive tests will be covered under Medicare Part A and Part B. This policy will determine coverage criteria and billing requirements for bladder cancer molecular testing services.
Action Required
By April 16, 2026: Review the full LCD L38647 policy text to understand specific coverage criteria for bladder cancer molecular classifiers. Billing team and providers must ensure any bladder cancer molecular testing meets the new Medicare coverage requirements. Update billing procedures and documentation requirements based on the detailed policy criteria once the full text is available.