Traditional MedicareCoverageLow 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
This is a new Medicare Local Coverage Determination establishing coverage criteria for prognostic and predictive molecular classifiers used in bladder cancer diagnosis and treatment planning. The policy defines when these specialized genetic tests will be covered by Medicare.
Action Required
By April 16, 2026: Billing team should review the full LCD policy text at the provided CMS URL to identify specific CPT/HCPCS codes and coverage requirements for bladder cancer molecular classifier tests. Update billing procedures for oncology and urology departments to ensure compliance with new Medicare coverage criteria.