Traditional MedicareCoverageMedium impact
MolDX: EndoPredict Breast Cancer Gene Expression Test
Medicare/CMS - LCD·Oncology, Hematology, Family Medicine +1 more·Local Coverage Determination
Effective date
Apr 16, 2026
We identified it
Jun 17, 2026
Summary
Medicare has established a new Local Coverage Determination (LCD) for the EndoPredict Breast Cancer Gene Expression Test, effective April 16, 2026. This policy will define coverage criteria and billing requirements for this genetic testing service under Medicare Part A and Part B.
Action Required
Before April 16, 2026: Billing team must review the full LCD L37356 policy text to identify specific CPT/HCPCS codes, coverage criteria, and documentation requirements for EndoPredict Breast Cancer Gene Expression Testing. Update billing system with any prior authorization requirements and ensure providers understand medical necessity criteria. Oncology and primary care staff should be trained on new coverage limitations.