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Comprehensive Genomic Profiling and Multigene Panel Testing for Solid Tumors - Medicare Advantage (Revised)
Effective date
Oct 12, 2026
Identified
Oct 10, 2026
Summary
Humana Medicare Advantage revised its policy on Comprehensive Genomic Profiling and Multigene Panel Testing for Solid Tumors, effective 10/12/2026. This is a policy update/revision to the original policy from 01/01/2024; the document provided does not contain specific details on what coverage or clinical criteria changed, only the updated effective date and related CMS references for billing and coding guidance across multiple MAC jurisdictions.
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What to do
Action · 4 steps
01By 10/12/2026: Billing and clinical teams should review the complete revised policy details (full text not provided in this excerpt) to identify any changes to coverage criteria, medical necessity requirements, or coding/billing guidance for comprehensive genomic profiling and multigene panel testing in solid tumor cases.
02Verify alignment with applicable MAC Local Coverage Determinations (LCDs) and Articles (LCAs) listed in the policy for your geographic jurisdiction (J5, J6, J8, J15, JE, JF, JH, JL, JJ, JM, JN).
03Confirm current prior authorization workflows and documentation requirements in the billing system.
04Since only the cover page and CMS reference table were provided, obtain the full policy document from the source URL to identify specific coding changes, clinical criteria updates, or reimbursement modifications.
Original notice
Comprehensive Genomic Profiling and Multigene Panel Testing for Solid Tumors - Medicare Advantage (Revised)
mcp.humana.com · Always check the source before changing claims.
Related changes
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