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Genetic Testing for Hematologic Malignancies and Suspected Myeloid Disorders - Medicare Advantage (Revised)
Effective date
Oct 12, 2026
Identified
Oct 10, 2026
Summary
Humana Medicare Advantage has revised its policy on genetic testing for hematologic malignancies and suspected myeloid disorders, effective 10/12/2026. This update clarifies coverage for comprehensive genomic profiling, multigene panels, targeted panels, lymphoid NGS panels, and single gene testing. The policy references applicable Medicare Administrative Contractor (MAC) Local Coverage Determinations (LCDs) by geographic jurisdiction, which govern actual billing and coverage determinations.
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What to do
Action · 5 steps
01By 2026-10-12: Billing team should verify that the practice's genetic testing protocols and prior authorization workflows align with this revised Humana Medicare Advantage policy.
02Identify which MAC jurisdiction(s) apply to your geographic service area using the provided MAC tables (J5, J8, J6, JK, J15, JE, JF, JH, JL, JJ, JM, JN), then cross-reference the applicable LCDs and billing articles listed for those jurisdictions.
03Update any internal documentation or billing system templates that reference the previous 01/01/2024 version of this policy.
04Confirm with Humana whether prior authorization requirements, covered test types (comprehensive genomic profiling, multigene panels, targeted panels, lymphoid NGS, or single gene testing), or documentation standards have changed from the prior version, as the source does not detail what was revised.
05Notify ordering providers of the effective date and any changes to coverage criteria for genetic testing in hematologic malignancies and myeloid disorders.
Original notice
Genetic Testing for Hematologic Malignancies and Suspected Myeloid Disorders - Medicare Advantage (Revised)
mcp.humana.com · Always check the source before changing claims.
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