Medicare local coverage
Medicare coverage for MolDX: Plasma-Based Genomic Profiling in Solid Tumors (LCD)
4 Medicare Administrative Contractors publish a local coverage determination (LCD) for MolDX: Plasma-Based Genomic Profiling in Solid Tumors. The snapshot lists 5 LCD records: 4 active, 1 retired.
An LCD applies only in the jurisdiction of the contractor that wrote it. Two contractors can cover the same service with different criteria, documentation requirements and covered diagnoses, so check the LCD from the contractor that processes your claims.
LCDs by contractor
| Contractor | LCD | Status | Last updated |
|---|---|---|---|
CGS Administrators, LLCMAC - Part A, MAC - Part B | L38065 | Active | Feb 13, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L39232 | Retired Feb 5, 2026 | Feb 5, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L39230 | Active | Jan 26, 2026 |
Palmetto GBAMAC - Part A, MAC - Part B | L38043 | Active | Feb 26, 2025 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L38168 | Active | Feb 18, 2025 |
An LCD marked Future has been finalized and is in its notice period; it applies from the effective date shown. LCD IDs link to the record on cms.gov.
Billing and coding articles
The codes live in the billing and coding article that goes with each LCD: the CPT and HCPCS codes the policy applies to, the ICD-10 codes that support medical necessity, and any modifier or documentation rules.
- A57867Palmetto GBAUpdated Jun 30, 2025
- A57917CGS Administrators, LLCUpdated Aug 3, 2026
- A57936WPS Insurance CorporationUpdated Jul 23, 2025
- A58973Noridian Healthcare Solutions, LLCUpdated Jan 26, 2026
- A58975Noridian Healthcare Solutions, LLCUpdated Feb 24, 2026
CMS also lists 4 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A57866, A57918, A59278, A59279.
Check claim lines against Medicare coverage
Coverage Check tells you whether a claim's diagnoses support Medicare LCD or NCD coverage for each procedure line, and shows the policy and CMS source behind each answer.
Related LCD topics
- Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms
- MolDX: Next-Generation Sequencing for Solid Tumors
- Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA)
- Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases
- MolDX: Molecular Testing for Solid Organ Allograft Rejection
- MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)
All Medicare LCD topics · National coverage determinations · Payer policies by payer
Source: CMS Medicare Coverage Database, via the public CMS Coverage API, snapshot Oct 25, 2026. LCDs change between snapshots; confirm the version in effect for your date of service on cms.gov before billing.