Local Coverage DeterminationOncology

Proposed LCD DL40226: MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Predictive Testing in Cancer — CGS

LCD-DL40226

Document details

Document type: Local Coverage Determination
Issuing body: MAC Contractor
Document ID: LCD-DL40226
Published: June 5, 2026
Effective date: See source document
MAC region: CGS Administrators

Summary

The proposed LCD on non-next generation sequencing targeted molecular panel tests may significantly impact billing practices for oncology providers. By establishing guidelines for which tests are elig

Proposed LCD on targeted molecular tests may affect oncology billing.

Affected specialty

Oncology alerts →

Source document

https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=40225&ver=6

CLV Intelligence summarizes publicly available federal publications. Not affiliated with or endorsed by any government agency.

Related alerts

FDA Approval: TRELSTAR (TRIPTORELIN PAMOATE) — Type 3 - New Dosage Form

Policy FDA-NDA022437 · Oncology

Critical

Trelstar (triptorelin pamoate) is an intramuscular injectable GnRH agonist indicated for advanced prostate cancer, billing under Medicare Part B as a physician-administered drug. As an established inj

View alert

FDA Approval: TRELSTAR (TRIPTORELIN PAMOATE) — Type 3 - New Dosage Form

Policy FDA-NDA021288 · Oncology

Critical

Trelstar (triptorelin pamoate) is an intramuscular injectable approved for a new dosage form under NDA021288, placing it firmly in the Medicare Part B billing pathway as a physician-administered drug.

View alert

FDA Approval: TRELSTAR (TRIPTORELIN PAMOATE) — Type 1 - New Molecular Entity

Policy FDA-NDA020715 · Oncology

Critical

Trelstar (triptorelin pamoate) is an intramuscular injectable indicated for prostate cancer, placing it squarely in the Medicare Part B billing pathway as a physician-administered drug. It is typicall

View alert

FDA Approval: ROMVIMZA (VIMSELTINIB) — Type 1 - New Molecular Entity

Policy FDA-NDA219304 · Oncology

High

Romvimza (vimseltinib) is an oral capsule kinase inhibitor approved via NDA219304, placing it squarely in the Medicare Part D billing pathway as a self-administered outpatient drug. As a new molecular

View alert