Genetic Testing for Hereditary Breast, Ovarian, Pancreatic and Prostate Cancer - Medicare Advantage

This Medicare Advantage policy covers germline genetic testing for hereditary breast, ovarian, pancreatic, and prostate cancer—including multigene panels and MolDX-defined lab‑developed tests—for patients with cancer or with personal/family histories suggestive of inherited cancer syndromes and for germline testing related to PARP inhibitor use. Coverage and specific requirements (e.g., panel/LDT definitions, repeat‑testing rules, and limits such as testing to a known familial variant) are determined by applicable CMS/MAC NCDs/LCDs/LCAs and MolDX rules and vary by MAC jurisdiction.

"MolDX: Repeat Germline Testing (L38351 / L38353)"

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