Medicare AdvantageCoverageLow impact
In Vitro Chemoresistance and Chemosensitivity Assays
Blue Cross Blue Shield of Rhode Island·RI · Oncology·Physician / Facility
Effective date
Jan 1, 2022
We identified it
Jun 19, 2026
Summary
Effective January 1, 2022, CPT code 0564T for oncology chemotherapeutic drug cytotoxicity assays will no longer be covered for Medicare Advantage plans (changed from requiring prior authorization to not covered). The code remains not medically necessary for commercial products.
Action Required
Immediately: Billing team must update system to mark CPT code 0564T as non-covered for Medicare Advantage plans. Stop submitting claims for this code to Medicare Advantage payers as they will be denied. Verify commercial plans continue to deny as not medically necessary.