LCDActive
MolDX: MGMT Promoter Methylation Analysis
L36192
Effective: August 7, 2025
Updated: December 31, 2025
Policy Summary
MGMT promoter methylation analysis is covered for adult patients with high-grade malignant glioma (for example, glioblastoma or anaplastic astrocytoma) when the patient can tolerate temozolomide or radiation and the treating physician will use the test results to decide first-line adjuvant therapy (radiation vs chemotherapy alone, or temozolomide vs other chemotherapy). Coverage is limited to adults and to the specified tumor types and assumes that adjuvant therapy is considered potentially beneficial for the patient.
Coverage Criteria Preview
Key requirements from the full policy
"Patient has a high-grade malignant glioma (e."
Sign up to see full coverage criteria, indications, and limitations.