Specialty intelligence

Genetic Testing Reimbursement Alerts

Daily CMS policy updates, MAC LCD revisions, and coding guidance for Genetic Testing billing teams. All alerts sourced directly from CMS, MAC contractor sites, and the Federal Register.

High-priority alerts active

Total alerts

1

Average signal

63/100

Sources monitored

15+

Latest Genetic Testing alerts

1

LCD L39948: MolDX: Molecular Testing for Identification and Management of Hereditary Transthyretin Amyloidosis — Noridian

Genetic Testing · Effective 2026-02-05

What is Genetic Testing reimbursement leakage costing you?

Calculate your ROI with Genetic Testing-specific CMS benchmarks pre-populated.

Calculate ROI →

MAC contractor coverage

Genetic Testing billing is subject to both national CMS policy and regional MAC contractor Local Coverage Determinations (LCDs). CLV Intelligence monitors all MAC contractor sites — Noridian, CGS, First Coast, NGS, Novitas, Palmetto GBA, and WPS — for LCD updates affecting Genetic Testing codes. Coverage criteria vary by contractor jurisdiction.

NoridianCGS AdministratorsFirst CoastNational Government ServicesNovitas SolutionsPalmetto GBAWPS

Get Genetic Testing alerts by email — free

Weekly digest of CMS and MAC policy changes for Genetic Testing billing teams.

Frequently asked questions

What MAC contractors issue LCDs for Genetic Testing billing?

Genetic Testing billing is subject to regional Local Coverage Determinations (LCDs) from all seven Medicare Administrative Contractors: Noridian, CGS Administrators, First Coast Service Options, National Government Services, Novitas Solutions, Palmetto GBA, and WPS Government Health Administrators. Coverage criteria and medical necessity requirements vary by contractor jurisdiction. CLV Intelligence monitors all MAC contractor sites daily for LCD updates affecting Genetic Testing codes.

How often does CMS update Genetic Testing reimbursement policy?

CMS updates the Physician Fee Schedule annually, effective January 1, with proposed rules published in the summer and final rules in November. MAC contractors issue LCD updates on a rolling basis throughout the year with no fixed schedule. The Federal Register publishes proposed and final rules affecting Genetic Testing reimbursement on a continuous basis. CLV Intelligence monitors all three sources daily and surfaces updates by signal strength.

What is a Local Coverage Determination (LCD) and how does it affect Genetic Testing billing?

A Local Coverage Determination (LCD) is a decision by a Medicare Administrative Contractor specifying under what clinical circumstances a particular service is covered within its geographic jurisdiction. For Genetic Testing billing teams, LCDs define medical necessity criteria, covered diagnoses, and documentation requirements for specific procedures. Failure to comply with LCD requirements is among the most common causes of Medicare claim denial in Genetic Testing practices.

Reimbursement guides & resources

Plain-language guides to the policy cycles that drive Genetic Testing reimbursement — the fee schedule, ICD-10, HCPCS, and Local Coverage Determinations.

Other specialties