Biomarkers Overview
JH · Effective Oct 1, 2015
46 active Medicare policies list 81542, 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 Sep 22, 2024
JE · Effective Sep 22, 2024
JF · Effective Sep 22, 2024
5 policies from 5 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 81542 |
|---|---|---|
| Tumor Markers | Mar 5, 2024 | Covered |
| Policy | Effective | Status of 81542 |
|---|---|---|
| Concert Genetic Testing Oncology: Algorithmic Assays | Not recorded | Referenced |
| Policy | Effective | Status of 81542 |
|---|---|---|
| Predictive and Prognostic Polygenic Testing |
JJ · Effective Sep 22, 2024
JM · Effective Sep 22, 2024
J5 · Effective Sep 22, 2024
J8 · Effective Sep 22, 2024
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 Nov 9, 2020
JE · Effective Dec 6, 2020
JF · Effective Dec 6, 2020
JJ · Effective Nov 8, 2020
JM · Effective Nov 8, 2020
J5 · Effective Nov 8, 2020
J8 · Effective Nov 8, 2020
J9 · Effective Oct 1, 2015
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
National · Effective Sep 22, 2024
National · Effective Sep 22, 2024
National · Effective Jan 22, 2026
J5 · Effective Jun 25, 2026
National · Effective Jul 1, 2026
National · Effective Jul 1, 2026
National · Effective Jul 1, 2026
J5 · Effective Jul 1, 2026
J5 · Effective Feb 1, 2024
National · Effective Feb 5, 2026
National · Effective Feb 3, 2022
National · Effective Dec 21, 2023
JL · Effective Jul 1, 2026
J9 · Effective Jul 1, 2026
J6 · Effective Jul 15, 2026
| Jun 14, 2026 |
| Covered |
| Policy | Effective | Status of 81542 |
|---|---|---|
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
| Policy | Effective | Status of 81542 |
|---|---|---|
| Gene Expression Profiling for Cancer Indications | May 1, 2026 | Covered with conditions |