Biomarkers Overview
JH · Effective Oct 1, 2015
49 active Medicare policies list 81231, and 5 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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JH · Effective Oct 1, 2015
JL · Effective Oct 1, 2015
J9 · Effective Jul 17, 2023
JH · Effective Jul 17, 2023
JL · Effective Jul 17, 2023
J15 · Effective Oct 1, 2015
JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
5 policies from 4 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 81231 |
|---|---|---|
| Concert Genetic Testing: Prenatal Diagnosis | Not recorded | Referenced |
| Concert Genetic Testing: Toxicology and Pharmacogenetics Version B | Not recorded | Referenced |
| Policy | Effective | Status of 81231 |
|---|---|---|
| Pharmacogenetic and Pharmacodynamic Testing | Feb 27, 2024 | Covered |
JM · Effective Oct 1, 2015
J5 · Effective Feb 16, 2017
J8 · Effective Feb 16, 2017
J15 · Effective Aug 3, 2020
JE · Effective Aug 17, 2020
JF · Effective Aug 17, 2020
JJ · Effective Jul 26, 2020
JM · Effective Jul 26, 2020
J5 · Effective Jul 26, 2020
J8 · Effective Jul 26, 2020
J15 · Effective Jun 7, 2020
JE · Effective Aug 3, 2020
JF · Effective Aug 3, 2020
JJ · Effective May 31, 2020
JM · Effective May 31, 2020
J5 · Effective Jun 14, 2020
J8 · Effective Jun 14, 2020
J9 · Effective Oct 1, 2015
J6 · Effective Jul 13, 2025
JK · Effective Jul 13, 2025
J9 · Effective Dec 12, 2021
JH · Effective Dec 12, 2021
JL · Effective Dec 12, 2021
National · Effective Jul 1, 2026
National · Effective Jul 1, 2026
National · Effective Jul 1, 2026
J5 · Effective Jul 1, 2026
National · Effective Jul 1, 2026
National · Effective Jul 1, 2026
National · Effective Nov 13, 2025
J5 · Effective Jul 1, 2026
J5 · Effective Jul 1, 2026
National · Effective Jul 1, 2026
National · Effective Jul 1, 2026
National · Effective Jul 1, 2026
JL · Effective Jul 1, 2026
J9 · Effective Jul 1, 2026
J6 · Effective Apr 1, 2026
JL · Effective Sep 10, 2026
J9 · Effective Sep 10, 2026
| Policy | Effective | Status of 81231 |
|---|
| Pharmacogenetic Testing | Jun 14, 2026 | Covered |
|---|
| Policy | Effective | Status of 81231 |
|---|---|---|
| Pharmacogenetic Testing | Jul 15, 2026 | Not covered |