Date: August 20, 2021
To: All Medical Assistance Program Providers
Re: Confirmation of Coverage for Biomarker Testing
This notice confirms the Department's coverage for biomarker testing, as required by Public Act 102-0203. Coverage is provided under both Medicaid fee-for-service and the managed care plans.
The Act requires the Department to follow the Illinois Insurance Code, which states that biomarker testing must be covered for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee's disease or condition when the test is supported by medical and scientific evidence. As the Department already covers this testing, no coverage changes are necessary.
Questions regarding this notice may be directed to a billing consultant in the Bureau of Professional and Ancillary Services at 877-782-5565 or the applicable managed care plan.
Kelly Cunningham, Administrator
Division of Medical Programs