Payer PolicyActive
LAB.00049 Artificial Intelligence-Based Software for Prostate Cancer Detection
ANTHEM-LAB.00049
Anthem
Effective: January 30, 2025
Updated: December 30, 2025
Policy Summary
- Service addressed: Artificial intelligence-based software used for prostate cancer detection (e.g., algorithms applied to digital pathology whole-slide images). - Coverage: Anthem considers this technology investigational/experimental and not medically necessary; it is not covered for any indication. - Limitations: The noncoverage applies to all clinical scenarios and uses (standalone or adjunctive), including services that might be billed under CPT 88399.
Coverage Criteria Preview
Key requirements from the full policy
"Use of artificial intelligence-based software for prostate cancer detection is consideredinvestigational and not medically necessaryfor all indications."
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