Pharmacogenomics Testing - MEDICAID - KENTUCKY

Kentucky Medicaid covers pharmacogenomic testing to assess genetic predictors of medication response, including comprehensive panels and specific drug–gene tests for psychiatric/behavioral health, oncology (chemo-sensitivity and checkpoint inhibitor response), acute and chronic pain, cardiovascular and neurologic conditions, and targeted variants such as DPYD, NUDT15/TPMT, and SLCO1B1. Coverage is limited to the policy’s listed indications — DPYD testing is specified for pre‑treatment dosing guidance or evaluation of severe/unexpected fluoropyrimidine toxicity — and several assays (e.g., IFNL3, Mind.Px, VitaRisk) are noted as investigational or of uncertain validity; eligibility remains subject to member benefit documents and medical director review.

"Clinical policy is not intended to preempt the judgment of the reviewing medical director or dictate to health care providers how to practice medicine."