A new clinical coverage policy, 1S-5 Genetic Testing for Susceptibility to Breast and Ovarian Cancer (BRCA), became effective on July 1, 2021.
The BRCA test uses deoxyribonucleic acid (DNA) analysis to identify harmful mutations, such as BRCA1&2 (breast cancer gene), which can increase risk of several cancers in both women and men.
Beneficiaries with a higher than average risk for development of certain cancers will be eligible to receive this service.
Please see policy 1S-5 on the Laboratory Services Clinical Coverage Policies webpage for eligibility, limitations, prior approval requirements and age restrictions.
Contact
NC Medicaid Contact Center, 888-245-0179