Genetic Tests: Once per Lifetime 

New Reimbursement Policy 

Genetic Tests: Once per Lifetime
(Policy G-23002, effective 01/01/2024) 

Beginning with dates of service on or after January 1, 2024, AMH Health, LLC will implement a new reimbursement policy titled Genetic Tests: Once per Lifetime. This policy identifies specific genetic tests allowed once in a member’s lifetime. During the member’s lifetime, the germline genotype will not change. However, the interpretation of the gene sequence may change due to recategorization of variants, or other factors. Repeat sequencing is not required for future interpretation of germline genotype, or re-analysis of previously sequenced data. 

The Related Coding section includes a Once per Lifetime Genetic Test coding list, which describes the genetic procedures that are limited to once per lifetime sequencing. Reinterpretation of the original results are not separately reimbursable. 

For additional information, please review the Genetic Tests: Once per Lifetime reimbursement policy at https://www.anthem.com/medicareprovider.