Genetic Testing for Diagnosis of Inherited Conditions - MEDICAID - KENTUCKY

This Kentucky Medicaid policy covers genetic testing of an individual’s DNA to diagnose inherited (heritable) conditions and to guide treatment decisions for symptomatic patients. Coverage is intended for individuals with clinical signs or symptoms suggestive of inherited disorders (examples include hemophilia and other inherited coagulation disorders, hematologic malignancy–related genetic evaluation, mitochondrial disorders, CANVAS, DRPLA, glycogen storage disease type I, etc.) and excludes testing solely for asymptomatic screening or for acquired (non‑genetic) causes; specific clinical criteria and other limitations are described in the policy’s Coverage Limitations section.

"No explicit coverage for genetic testing in the absence of clinical signs or symptoms (testing must be to confirm a diagnosis in symptomatic individuals)."

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