Draft Genetic Testing Policies
Effective for dates of service on or after June 15, 2025, the changes listed in the document below will apply to Carelon Genetic Testing Clinical Appropriateness Guidelines. As part of the Carelon guidelines semi-annual review process, these updates are focused on advancing efforts to drive clinically appropriate, safe and affordable healthcare services.
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Comment on Draft Policies
To ensure that the development of medical policies occurs through an open, collaborative process, we welcome comments about medical policies that are in the draft stage.
Participating providers are invited to submit scientific, evidence-based information, professional consensus opinions and other information supported by medical literature relevant to these draft policies for consideration.
Comments are accepted for 45 days from the posting date listed on the draft policy.
Make sure your voice is heard by providing feedback directly to us:
- Complete our online medical policy feedback form, or
- Send comments by mail or fax to:
Patrius Health
Attn: Health Management - Medical Policy
P.O. Box 12364
Birmingham, AL 35202-2364
Fax: 205-220-0878
Precertification of Genetic Testing Services
Some genetic testing services require precertification. Click the link below to view a list of applicable CPT/HCPCS codes.