Does S3870 require prior authorization?

No, S3870 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for S3870?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

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`S3870`, Comparative genomic hybridization (cgh) microarray testing for developmental

HCPCS/CPT

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

Medical Records Documentation Used for Reviews: Medical records documentation may be required to assess whether the member meets the clinical criteria for coverage but does not guarantee coverage of the service requested; refer to the guidelines titled Medical Records Documentation Used for Reviews.
Pre-test genetic counseling is strongly recommended in order to inform persons being tested about the advantages and limitations of the test as applied to a unique person.

Comprehensive patient pretest and posttest genetic counseling from an obstetrician-gynecologist or other health care provider with genetics expertise regarding the benefits, limitations, and results of chromosomal microarray analysis is essential. CMA should not be ordered without informed consent, which should include discussion of the potential to identify findings of uncertain significance, non-paternity, consanguinity, and adult-onset disease.

Documentation of the clinical indication/diagnosis (e.g., ultrasound findings, stillbirth/intrauterine fetal demise, pregnancy loss/POC testing, developmental delay/intellectual disability, autism spectrum disorder, congenital heart disease, multiple anomalies) to support medical necessity.

When a CNV of unknown clinical significance is detected, parental testing should be considered to determine if the CNV is de novo or inherited (ACMG: "if a CNV is identified that has unknown clinical significance, the parents of the proband should be tested").

Key Coverage Criteria

Pre-test genetic counseling is strongly recommended in order to inform persons being tested about the advantages and limitations of the test as applied to a unique person.
Chromosome microarray testing using array comparative genomic hybridization (aCGH) and/or single-nucleotide polymorphism (SNP) array is proven and medically necessary for the following:
Evaluation of an embryo/fetus in the following cases:
Intrauterine Fetal Demise or Stillbirth
Testing the products of conception following pregnancy loss
Individuals undergoing invasive prenatal testing (i.e., amniocentesis, chorionic villus sampling, or fetal tissue sampling)

6 Active Policies

AMBETTER-CG-Multi-Inher-DO.-Intel-Dis.-DD-2025.1, Concert Genetic Testing: Multisystem Inherited Disorders, Intellectual Disability, and Developmental Delay

CARELON-chromosomal-microarray-analysis-2026-06-14-updated-2026-07-01, Chromosomal Microarray Analysis

UHC-POL-chromosome-microarray-testing, Chromosome Microarray Testing (Non-Oncology Conditions)

REGENCE-GT58, Chromosomal Microarray Analysis (CMA) or Copy Number Analysis for the Genetic Evaluation of Patients with Developmental Delay, Intellectual Disability, Autism Spectrum Disorder, or Congenital Anomalies

UMR-POL-UMR-chromosome-microarray-testing, Chromosome Microarray Testing (Non-Oncology Conditions)

SUREST-POL-SUREST-chromosome-microarray-testing, Chromosome Microarray Testing (Non-Oncology Conditions)

`S3870`, Comparative genomic hybridization (cgh) microarray testing for developmental

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

6 Active Policies

Related Codes

Have a follow-up question?

S3870, Comparative genomic hybridization (cgh) microarray testing for developmental

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

6 Active Policies

Related Codes

Have a follow-up question?

`S3870`, Comparative genomic hybridization (cgh) microarray testing for developmental