Payer PolicyActive
CG-LAB-20 Thyroid Testing
ANTHEM-CG-LAB-20
Anthem
Effective: October 1, 2025
Updated: December 30, 2025
Policy Summary
This policy addresses thyroid function testing (e.g., TSH, free T4, and free/total T3). It is covered as medically necessary to evaluate signs or symptoms of thyroid disease, to evaluate/assess/monitor confirmed or suspected thyroid disease, or to assess thyroid function when risk factors are present; it is not covered when these criteria are not met, including routine screening without risk factors. Coverage is limited to clinically indicated testing, with TSH as the first-line test and additional T4/T3 testing as appropriate.
Coverage Criteria Preview
Key requirements from the full policy
"Thyroid function testing is consideredmedically necessaryfor individuals who meet any of the following indications:"
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