4Kscore Test Algorithm

The 4Kscore test is covered for men aged 45 and older being considered for prostate biopsy (initial or after a negative biopsy) who have a confirmed moderately elevated PSA (>3 and <10 ng/mL, or >=4 and <10 ng/mL if >75 years), provided all four kallikrein proteins and required clinical inputs (age, DRE, prior biopsy history) are present. Coverage requires documented shared decision-making provided to the laboratory and PSA verification under standardized conditions in a CLIA-approved lab; tests missing required components or lacking shared decision-making documentation are not payable.

"Testing is covered for men age >=45 years being considered for prostate biopsy (prior to an initial biopsy or following a negative biopsy)."

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