Since we began transitioning genetic testing to the new Prior Authorization and Notification platform in June 2021, we have offered a prior authorization penalty waiver for genetic and molecular tests.
On Jan. 1, 2022, the penalty waiver expired. This means for those genetic and molecular tests that require prior authorization/advanced notification, ordering providers must request prior authorization using the Prior Authorization and Notification platform or by calling 877-303-7736.
Performing laboratories can submit advance notifications. If a test requires prior authorization with clinical criteria, the request must be submitted by the ordering provider.