Changes in Familial/Personal History Criteria for Medicaid BRCA Genetic Testing

Effective for dates of service on or after April 1, 2014, Medicaid is implementing changes to the BRCA coverage policy for Medicaid recipients. The coverage policy criteria is now more inclusive of ages, gender, types of cancers, and maternal/paternal family history of cancer. Physicians, nurse practitioners, physician assistants and midwives may order this laboratory test for their patients when clinically indicated and medically necessary.