Effective 11/01/2021 coverage of non-invasive prenatal trisomy screening using cell-free fetal DNA (deoxyribonucleic acid) has been expanded to include pregnant members age 30 and older.
This benefit also will include twin pregnancies, but not higher multi-gestational pregnancies.
Consistent with current policy, non-invasive prenatal trisomy screening will continue to be covered when at least one of the following criteria is met:
- Either parent has a family history of aneuploidy in a first* or second** degree relative.
- Standard serum screening or fetal ultrasonographic findings indicate an increased risk of aneuploidy.
- Parent(s) have a history of a previous pregnancy with a trisomy.
- Either parent is known to have a Robertsonian translocation.
*First degree relatives: Parents, children, siblings
** Second degree relatives: Grandparents, aunts and uncles, nieces and nephews, and grandchildren
Note: This is an update to the October 2014 Medicaid Update article titled NYS Medicaid Now Covers Non-invasive Prenatal Testing for Trisomy 21, 18 and 13.
You can find the updated version of this policy (NY Medicaid) here.
Recent Blog Posts:
- MVP (NY/VT)- Reimbursement sick visit and Preventative Care on the same day.
- MVP Health Plans: reimbursement of sick E&M codes billed w/preventative codes -05/01/23
- Michigan Medicaid: reimburses for Doula Services-01/01/23
- UHC NY Community Plan Referral requirement change-effective immediately
- UHC Oxford- updated Prior Auth changes 01/01/2023