Updates to Clinical Coverage Policy 1S-11: Genetic Testing Gene Expression

Clinical Coverage Policy 1S-11 will include coverage for AlloMap® effective Jan. 1, 2026.

This bulletin applies to NC Medicaid Direct and NC Medicaid Managed Care.

Effective Jan. 1, 2026, Clinical Coverage Policy (CCP) 1S-11 Genetic Testing - Gene Expression is updated to include coverage for AlloMap®, a gene expression profiling test used in the surveillance of heart transplant rejection. Providers should consult CCP 1S-11 for detailed coverage criteria, billing guidance and documentation requirements.

For beneficiaries enrolled in NC Medicaid Managed Care, providers should contact the appropriate health plan for that beneficiary.

Contact

NCTracks Call Center: 800-688-6696 
NC Managed Care health plans

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