Molecular Diagnostic and Genetic Testing (MD/GT)
Preauthorization of MD/GT is required for commercial, Medicaid and Medicare Advantage (MA) health maintenance organization (HMO) and preferred provider organization (PPO) members. In Puerto Rico, preauthorization is required for all MI Salud (i.e., Medicaid) and commercial products.
Preauthorization is not required for:
- MA Private Fee-for-Service (PFFS) plans
- Risk groups
- CarePlus members
- HumanaOne members
- MA members in HMO groups in Florida, Illinois, Nevada, Arizona and California