Genomic and Molecular Biomarker Testing for Cancer - MEDICAID - SOUTH CAROLINA
HUMANA-GENOMIC-AND-MOLECULAR-BIOMARKER-TESTING-FOR-CANCER-SC-MEDICAID
This South Carolina Medicaid policy covers genomic and molecular biomarker testing for cancer in patients, including concurrent (paired) DNA/RNA genetic testing, comprehensive genomic profiling platforms (eg, PGDx, Praxis), single‑gene assays (eg, IDH1/2, MGMT, PIK3CA, TERT), tumor markers, and targeted hereditary panels such as Lynch syndrome (MLH1, MSH2, MSH6, PMS2). Coverage is limited to the specific tests and clinical contexts listed (eg, solid tumors, hereditary colorectal/Lynch syndrome, select hematologic/myeloid indications), with RNA‑based assays generally required as add‑ons to DNA testing (eg, +RNAinsight for colorectal/Lynch panels); the provided excerpt does not specify additional indications, frequency limits, or prior‑authorization requirements.
"RUNX1 gene testing (81334) for systemic mastocytosis."
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