Genetic Testing Company | The DNA Diagnostic Experts | GeneDx

Medicaid/Medicare

Medicaid

GeneDx is a registered provider with the Medicaid plans listed below. Although GeneDx is a registered provider with these plans, most of them do not cover genetic testing. Prior-authorization is required by most of the Medicaid plans. Many plans only have coverage for specific tests. Therefore, please contact GeneDx or your State Medicaid plan to find out if specific tests are covered under the approved services. In an instance where we receive a Medicaid sample without a prior authorization for a Medicaid plan which requires a PA, the test will go on hold and not proceed in the lab. 

Medicaid Plans    
Alabama Medicaid
Alaska Medicaid
Arizona Medicaid
Arkansas Medicaid
Colorado Medicaid
Connecticut Medicaid
Florida Medicaid
Georgia Medicaid
Idaho Medicaid
Illinois Medicaid
Indiana Medicaid
Iowa Medicaid
Kansas Medicaid
Kentucky Medicaid
Maine Medicaid
Maryland Medicaid
Massachusetts Medicaid
Medi-Cal (California)
Michigan Medicaid
Minnesota Medicaid
Mississippi Medicaid
Missouri Medicaid
Montana Medicaid
Nebraska Medicaid
New Mexico Medicaid
New York Medicaid
North Carolina Medicaid
North Dakota Medicaid
Ohio Medicaid
Oklahoma Medicaid
Oregon Medicaid
Pennsylvania Medicaid
South Carolina Medicaid
Tennessee Medicaid
Texas Medicaid
Utah Medicaid
Vermont Medicaid
Virginia Medicaid
Washington Medicaid
Washington D.C. Medicaid
West Virginia Medicaid
Wisconsin Medicaid

Medicare

GeneDx is contracted as an in-network provider with Medicare. Currently Medicare has published criteria for Hereditary Breast and Ovarian Cancer (HBOC) and Hereditary Colorectal Cancer/Lynch Syndrome. Please refer to our Medicare Criteria Form to determine if your patient meets the necessary criteria to get coverage for hereditary cancer genetic testing. If the patient does not meet Medicare’s pre-determined criteria, a completed Advance Beneficiary Notice (ABN) is required. For all other non hereditary cancer genetic testing, an ABN is required.

Our customer service department will reach out to the physician to obtain a completed ABN if:

 

ABN Form

 

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