Reimbursement Policy: New Genetic and Molecular Testing

Effective August 1, 2025, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is implementing a new Genetic and Molecular Testing reimbursement policy.

Blue Cross NC will implement guidelines set forth by industry authorities in the reimbursement of genetic testing in accordance with best practice standards, which are detailed within the policy. Please see the related policy notification for more information.

Blue Cross NC is making this change to ensure accurate and consistent coding and reimbursement for genetic testing services.

This new policy will apply to Commercial, Inter-Plan Program (IPP) Host, and Federal Employee Program (FEP). This will not apply to IPP Home and Medicare Advantage.