Skip to Main Content

Las cartas sobre el reembolso del MLR se enviaron por correo el 30 de septiembre. Revise su correo antes del 15 de octubre para obtener más información. Obtenga más información.

Las cartas sobre el reembolso del MLR se enviaron por correo el 30 de septiembre. Revise su correo antes del 15 de octubre para obtener más información. Obtenga más información.

News

Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing (CP.MP.209)

Fecha: 11/03/26

Thank you for your continued partnership with Ambetter. As you know, we continually review and update our payment and utilization policies to ensure that they are designed to comply with industry standards while delivering the best patient experience to our members. We are writing today to inform you of the revision to existing policies Ambetter will be implementing effective with Dates of Service starting 5/15/2026.

Policy Number

Policy Name

Policy Description

Lines of Business

CP.MP.209

Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing

Multiplex molecular panels are used for the qualitative detection of nucleic acid from multiple viral, parasitic, and bacterial pathogens that cause a variety of illnesses, including infectious gastroenteritis and infectious colitis.1 The Food and Drug Administration (FDA) has cleared several panels for diagnosis of gastrointestinal infections. This policy addresses the medical necessity criteria for Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing.

Medicaid

Marketplace

Commercial

Thank you for your continued participation and cooperation in our ongoing efforts to render quality health care to our members. We look forward to helping you provide the highest quality of care for our members.