Genetic Testing Policies
Patrius Health partners with Carelon Medical Benefits Management, an independent company, to administer advanced imaging solutions for our customers.
Note: Coverage is subject to the member's specific benefits. Group-specific policies will supersede these policies when applicable. Please refer to the member's benefit plan.
Draft Genetic Testing Policies
Effective June 30, 2024, the following updates apply to Carelon's Genetic Testing Clinical Appropriateness Guidelines. As part of the Carelon guideline annual review process, these updates focus on advancing efforts to drive clinically appropriate, safe and affordable healthcare services.
To continue to the Carelon website to view genetic testing policies, click "Accept" below.
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.