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Liquid Biopsy - Medicare Advantage (Revised)
Effective date
Aug 3, 2026
Identified
Aug 22, 2026
Summary
Humana's Medicare Advantage Liquid Biopsy coverage policy was revised with an effective date of 2026-08-03, and its updated coding information applies from that date. Under the policy, specific plasma-based tests are medically reasonable and necessary when their listed criteria are met, including that tissue-based multigene panel testing is infeasible or, for non-small cell lung cancer, has shown no actionable mutations. The policy states that CellSearch Circulating Multiple Myeloma Cell Test (0337U), LungLB (0317U) and DEPArray HER2 Test (0009U) are not considered medically reasonable and necessary.
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What to do
Action · 7 steps
01Already effective 2026-08-03: Billing team: bill Caris Assure (0485U), Guardant360 (0326U), Liquid HALLMARK (0571U), Northstar Select (0487U) and Resolution ctDx Lung (0179U) only when all LCD L39230 indications are met and tissue-based multigene panel testing is infeasible (for example, quantity not sufficient, or invasive biopsy is medically contraindicated) or, in non-small cell lung cancer, tissue-based testing has shown no actionable mutations.
02Bill FoundationOne Liquid CDx (0239U) and Guardant360 CDx (0242U) only when all NCD 90.2 indications are met and the same tissue-testing condition is met.
03Bill InVisionFirst-Lung (0388U) only when all LCD L37870 indications are met and the same tissue-testing condition is met.
04Bill Tempus xF/xF+ (NC) only when all LCD L38043 indications are met and the same tissue-testing condition is met.
05In jurisdictions J6/JK, JH/JL and JN, a specific molecular diagnostic test or LDT is not covered unless it meets the clinical utility criteria and either has a MolDX Program approved technical assessment or FDA approval or clearance and is performed within FDA labeling indications.
06Services that do not meet the criteria are not medically reasonable and necessary and may result in unnecessary exposure to potential complications.
07Tests considered screening without clinical signs and symptoms, tests that confirm a diagnosis, tests to determine risk, tests that measure process quality, tests without diagnosis-specific indications, and investigational tests outside a clinical trial would be denied as Medicare Excluded tests.
Codes mentioned
8615286153
Original notice
Liquid Biopsy - Medicare Advantage (Revised)
mcp.humana.com · Always check the source before changing claims.
Related changes
See all Humana changes →Liquid Biopsy - Medicare Advantage (Revised)MediumEffective Aug 3, 2026 · Medicare AdvantageLiquid Biopsy - Medicare Advantage (Revised)MediumNo effective date · Medicare AdvantageLiquid Biopsy - Medicare Advantage (Revised)MediumEffective May 1, 2026 · Medicare AdvantageBrowse every Humana change in the policy list