This bulletin article applies to NC Medicaid Direct and NC Medicaid Managed Care.
Effective Oct. 1, 2024, genetic testing policies have been updated accordingly. Refer to the New Covered CPT Codes for Genetic Testing bulletin posted July 1, 2024 for information on the new covered CPT codes.
| Policy | Status |
|---|---|
| 1S-4 Genetic Testing | Terminated |
| 1S-5 Genetic Testing for Susceptibility to Breast and Ovarian Cancer (BRCA) | Terminated |
| 1S-7 Gene Expression Profiling for Breast Cancer | Terminated |
| 1S-9 Genetic Testing for Diagnosis & Treatment | New Policy |
| 1S-10 Genetic Testing – Carrier & Prenatal | New Policy |
| 1S-11 Genetic Testing – Gene Expression | New Policy |
| 1S-12 Genetic Testing – Next Generation Sequencing | New Policy |
Existing coverage has not been revoked; rather, it will be reorganized within the framework of the new policy structure. Please consult the relevant clinical coverage policies for detailed information regarding this organization.
For beneficiaries enrolled in a managed care plan (PHP), providers should contact the appropriate health plan for that beneficiary.
Contact
NCTracks Call Center: 800-688-6696
NC Managed Care health plans