Molecular Biomarker Testing for Noncancer Indications - MEDICAID - KENTUCKY

This Humana Medicaid (KY) medical coverage policy covers a limited set of molecular biomarker tests for noncancer indications: CSF Aβ and Tau testing for patients with diagnosed Alzheimer disease being considered for FDA‑approved amyloid monoclonal antibody therapy; beta‑hexosaminidase enzyme testing for GM2 gangliosidoses when specified counseling and clinical or reproductive criteria are met; and noninvasive prenatal multiple marker serum screening (NIPS) under indicated CPT codes. The policy explicitly excludes a broad list of noncancer GEP and MAAA tests (eg, many cardiovascular, psychiatric, longevity, autism, Barrett's esophagus, IBD, Kawasaki, diabetes, pulmonary classifiers) and other specific tests (APOL1, MTHFR, ST2), and requires documentation such as pre/post genetic counseling, clinical diagnostic documentation, and evidence of consideration for targeted therapy where applicable.

" - Endometrial implantation prediction (Igenomix Endometrial Receptivity Analysis [0253U])"