Biomarkers Overview
JH · Effective Oct 1, 2015
47 active Medicare policies list 81291, and 18 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 Jun 16, 2016
JF · Effective Jun 16, 2016
18 policies from 8 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 81291 |
|---|---|---|
| Fetal Fibronectin, Inflammatory Biomarkers, and Salivary Hormone Testing for Preterm Labor | Apr 6, 2023 | Covered |
| Genetic Testing | Feb 27, 2024 | Covered |
| Infertility | Feb 15, 2024 | Covered |
| Pemetrexed Products | Feb 20, 2024 | Covered |
| Pharmacogenetic and Pharmacodynamic Testing | Feb 27, 2024 | Covered |
| Polymerase Chain Reaction Testing: Selected Indications | Feb 9, 2024 | Covered |
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
J5 · Effective Apr 16, 2016
J8 · Effective Apr 16, 2016
J15 · Effective Oct 1, 2015
JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
J5 · Effective Feb 16, 2017
J8 · Effective Feb 16, 2017
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 Oct 1, 2015
JK · Effective Oct 1, 2015
National · Effective Jun 19, 2025
National · Effective Jan 22, 2026
National · Effective Nov 7, 2024
J5 · Effective Nov 7, 2024
National · Effective Jul 1, 2026
National · Effective Jul 1, 2026
National · Effective Jul 1, 2026
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 Jul 15, 2026
J9 · Effective Jan 1, 2024
| Recurrent Pregnancy Loss | Feb 15, 2024 | Covered |
|---|
| Vitiligo | Feb 16, 2024 | Covered |
|---|
| Policy | Effective | Status of 81291 |
|---|---|---|
| Carrier Screening in the Reproductive Setting | Sep 19, 2026 | Covered |
| Carrier Screening in the Reproductive Setting | Sep 20, 2025 | Covered |
| Pharmacogenetic Testing | Jun 14, 2026 | Covered |
| Policy | Effective | Status of 81291 |
|---|---|---|
| Genetic and Coagulation Testing for Noncancer Blood Disorders | Feb 2, 2026 | Covered |
| Molecular Biomarker Testing for Noncancer Indications | Aug 26, 2026 | Covered |
| Policy | Effective | Status of 81291 |
|---|---|---|
| Concert Genetic Testing: Nutrition and Metabolism | Not recorded | Referenced |
| Policy | Effective | Status of 81291 |
|---|---|---|
| Biomarker Testing in Risk Assessment and Management of Cardiovascular Disease | Jul 15, 2026 | Covered |
| Policy | Effective | Status of 81291 |
|---|---|---|
| Biomarker Testing in Risk Assessment and Management of Cardiovascular Disease | Jul 15, 2026 | Covered |
| Policy | Effective | Status of 81291 |
|---|---|---|
| Biomarker Testing in Risk Assessment and Management of Cardiovascular Disease | Jul 15, 2026 | Covered |
| Policy | Effective | Status of 81291 |
|---|---|---|
| Biomarker Testing in Risk Assessment and Management of Cardiovascular Disease | Jul 15, 2026 | Covered |