ProMark® Risk Score

This policy provides limited coverage for the ProMark® risk score (Metamark Genetics) to assist in identifying patients with early-stage, needle-biopsy–proven prostate cancer who may be appropriate for conservative (non-definitive) management instead of surgery or radiation. The policy text specifies the intended clinical use but does not define exact staging thresholds, age limits, documentation requirements, or frequency limits, which may require manual review or supplemental guidance.

"ProMark testing is covered to help determine which patients with early-stage, needle-biopsy–proven prostate cancer can be managed conservatively rather than treated with definitive surgery or radia..."

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