MolDX: Pharmacogenomics Testing (L38335) - R2 - Effective July 3, 2025

Date Posted: July 3, 2025

This MolDX Local Coverage Determination (LCD) has been revised under contractor numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, and NMI), and 01312 (NV).

Effective Date: July 3, 2025

Summary of Changes:

Under Bibliography revised the broken hyperlink for the 40th reference and changes were made to citations to reflect AMA citation guidelines.

Updated Analysis of Evidence (Rationale for Determination) paragraphs #1, #5, and #8 to mirror the paragraphs used presently by the MolDX team at Palmetto GBA as part of an annual review. Revision history dates and language may not exactly match the MolDX PGBA revision history. However, these revisions do not change coverage or guidance.

Visit the Noridian Molecular Diagnostic Services webpage to view the Active MolDX LCD or access it via the CMS Medicare Coverage Database (MCD).

Last Updated Jul 03 , 2025