CurrentBlue KCPolicy POL-PP-281

Folate Testing Payment and Coverage

Defines Blue KC's coverage and reimbursement stance for serum and RBC folate testing and folate receptor autoantibody testing across impacted lines of business and provider types.

Policy Summary

PayerBlue KC

PolicyFolate Testing Payment and Coverage

Policy CodePolicy POL-PP-281

Change TypeNo material change

Effective Date

Next Review DateJul 1, 202619d

Key ActionContact Blue KC provider hotlines to confirm member eligibility, benefit limits and coverage for folate testing.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

2covered clinical indications

0RBC folate reimbursed

1proprietary test listed

Multiplelines of business impacted

Coverage Criteria for Folate Testing

Folate testing coverage criteria

Measurement of serum folate concentration may be covered when ALL of the following apply:

ALL of the following

ONE of
- Individual has megaloblastic or macrocytic anemia
- Individual has undergone or is scheduled for a bariatric procedure (e.g., Roux-en-Y gastric bypass, sleeve gastrectomy, biliopancreatic diversion/duodenal switch)
Indication is not one of the situations explicitly listed as not reimbursed

Not covered tests

Policy Summary

PayerBlue KC

PolicyFolate Testing Payment and Coverage

Policy CodePolicy POL-PP-281

Change TypeNo material change

Effective Date

Next Review DateJul 1, 202619d

Key ActionContact Blue KC provider hotlines to confirm member eligibility, benefit limits and coverage for folate testing.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Coding and Reimbursement Details

Folate-related test codesCPT

82746	Folic acid; serum
82747	Folic acid; RBC
0399U	Neurology (cerebral folate deficiency), serum, detection of anti-human folate receptor IgG-binding antibody and blocking autoantibodies (FRAT®) — Religen Inc

RBC folate reimbursement

RBC folate reimbursement stanceRed blood cell (RBC) folate measurement may not be reimbursed for all indications.

Related codeCPT 82747 — Folic acid; RBC.

Applicability noteApplies to all lines of business and claims unless benefit language or Provider Service Agreement specifies otherwise (coverage determined by member benefits at time of request).

Provider Actions and Verification

Note

Coverage verification and contact

Coverage of any service is determined by the date of service, the member's eligibility and benefit limits for the service(s) rendered, all terms of the Provider Service Agreement, and applicable coding rules and guidelines. Final payment is subject to claims adjudication and industry-standard edits. For confirmation of which services may be eligible for coverage and for questions about medical necessity determinations, contact the appropriate Blue KC provider hotline below.

Commercial Provider Hotline: 816-395-3929
Affordable Care Act Provider Hotline: 866-859-3822
Blue Medicare Advantage Provider Hotline: 866-508-7140

Definitions

Folate (vitamin B9)

DefinitionFolate (vitamin B9) is a water-soluble vitamin obtained from the diet involved in transfer of methyl groups in multiple biochemical pathways, including nucleic acid biosynthesis and methionine/homocysteine metabolism.

Clinical relevanceFolate metabolism is closely linked to vitamin B12 (cobalamin); deficiency can be implicated in many disease states but is usually remedied by diet or folic acid supplementation.

Testing coverage noteMeasurement of serum folate concentration may be covered for megaloblastic or macrocytic anemia and for patients who have undergone or are scheduled for certain bariatric procedures; other indications may not be reimbursed.

Folate receptor autoantibody testing (e.g., FRAT®)

DefinitionFolate receptor autoantibody testing (e.g., FRAT®) detects anti‑human folate receptor IgG‑binding and blocking autoantibodies using ELISA and functional blocking assays.

Proprietary test exampleFRAT® (Folate Receptor Antibody Test) — Lab/Manufacturer: Religen Inc.

Coverage stanceFor all situations, folate receptor autoantibody testing may not be reimbursed due to lack of published scientific literature confirming clinical benefit.