Laboratory In Vitro Chemo-Resistance and ChemoSensitivities Assay
Humana Medicare Advantage payment policy describing the reimbursement stance for in vitro chemotherapy sensitivity and resistance assays and listing specific procedure codes and proprietary tests; applies to Humana Medicare Advantage products and providers submitting claims.
In vitro chemotherapy sensitivity and resistance assays (listed CPT/HCPCS and proprietary tests) are not reimbursable for Medicare Advantage plans.
Coverage Criteria
Coverage criteria — Medicare Advantage
Stance and specific code/test applicability for Medicare Advantage products:
ALL of the following
ALL of the following
- In vitro chemotherapy sensitivity and resistance assays and the listed CPT/HCPCS/proprietary tests are not reimbursable under Medicare Advantage.
See listed codes and proprietary tests below.
ALL of the following
Codes explicitly listed
- CPT 81535 — Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology; ChemoFX (Helomics, Corp.)
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.