Traditional MedicareCoverageMedium impact
MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells
Medicare/CMS - LCD·Oncology, Hematology, Pathology·Local Coverage Determination
Effective date
Apr 16, 2026
We identified it
Jun 17, 2026
Summary
Medicare has updated Local Coverage Determination L38584 for phenotypic biomarker detection from circulating tumor cells, effective April 16, 2026. This policy change affects coverage criteria and billing requirements for specialized cancer diagnostic testing that analyzes biomarkers from circulating tumor cells.
Action Required
By April 16, 2026: Review and understand updated coverage criteria for phenotypic biomarker detection from circulating tumor cells under LCD L38584. Billing team should verify that any claims for these specialized cancer diagnostic tests meet the new coverage requirements. Contact CGS Administrators, LLC for specific billing guidance if your practice performs or orders these tests.