Medicare local coverage
Medicare coverage for MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Targeted Therapy in Cancer (LCD)
4 Medicare Administrative Contractors publish a local coverage determination (LCD) for MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Targeted Therapy in Cancer. The snapshot lists 4 LCD records: 4 active.
An LCD applies only in the jurisdiction of the contractor that wrote it. Two contractors can cover the same service with different criteria, documentation requirements and covered diagnoses, so check the LCD from the contractor that processes your claims.
LCDs by contractor
| Contractor | LCD | Status | Last updated |
|---|---|---|---|
CGS Administrators, LLCMAC - Part A, MAC - Part B | L40226 | Active | Aug 21, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L40222 | Active | Aug 21, 2026 |
Palmetto GBAMAC - Part A, MAC - Part B | L40210 | Active | Aug 21, 2026 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L40278 | Active | Aug 21, 2026 |
An LCD marked Future has been finalized and is in its notice period; it applies from the effective date shown. LCD IDs link to the record on cms.gov.
Billing and coding articles
The codes live in the billing and coding article that goes with each LCD: the CPT and HCPCS codes the policy applies to, the ICD-10 codes that support medical necessity, and any modifier or documentation rules.
- A60236Palmetto GBAUpdated Aug 21, 2026
- A60239Noridian Healthcare Solutions, LLCUpdated Aug 21, 2026
- A60241CGS Administrators, LLCUpdated Aug 21, 2026
- A60310WPS Insurance CorporationUpdated Aug 21, 2026
CMS also lists 3 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A60495, A60527, A60530.
Check claim lines against Medicare coverage
Coverage Check tells you whether a claim's diagnoses support Medicare LCD or NCD coverage for each procedure line, and shows the policy and CMS source behind each answer.
Related LCD topics
- MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms
- MolDX: Next-Generation Sequencing for Solid Tumors
- MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies
- MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis
- MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
- MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer
All Medicare LCD topics · National coverage determinations · Payer policies by payer
Source: CMS Medicare Coverage Database, via the public CMS Coverage API, snapshot Oct 25, 2026. LCDs change between snapshots; confirm the version in effect for your date of service on cms.gov before billing.