CommercialCoverageMedium impact
MP 2.04.02 - Germline Genetic Testing for BRCA1 or BRCA2 for Hereditary Breast/Ovarian Cancer Syndrome and Other High-Risk Cancers - Policy statement regarding genetic testing for systemic therapy options updated to include individuals with high-risk, early-stage breast cancer. Other minor edits made to policy statements and policy guidelines to reflect current NCCN guidelines.
Blue Cross of Idaho·ID · Oncology, OB-GYN, Family Medicine +1 more·Medical Policy
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho expanded coverage for BRCA1/BRCA2 genetic testing to include individuals with high-risk, early-stage breast cancer for determining systemic therapy options. The policy also includes minor updates to align with current NCCN guidelines for hereditary breast/ovarian cancer syndrome testing.
Action Required
Review current BRCA1/BRCA2 genetic testing orders and documentation to ensure alignment with expanded coverage criteria. Billing team should verify that claims for genetic testing in high-risk, early-stage breast cancer patients include appropriate documentation for systemic therapy decision-making. Update any internal coverage guidelines to reflect the expanded criteria.