CommercialCoverageMedium impact
Non-Invasive Prenatal Testing - (Effective Date - 2026-08-17) 2.02.25
Excellus BlueCross BlueShield·OB-GYN, Family Medicine·Lab Tests (pathology)
Effective date
Aug 17, 2026
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield updated their Non-Invasive Prenatal Testing (NIPT) policy effective August 17, 2026. The policy covers NIPT for trisomy 21, 13, and 18 screening in singleton pregnancies but considers multiple gestations, microdeletions, and sex chromosome aneuploidy as investigational (not covered).
Action Required
By August 17, 2026: Billing team must update systems to ensure NIPT claims are only submitted for singleton pregnancies screening for trisomy 21, 13, and 18. Flag CPT codes 0060U (twin zygosity testing) and 81422 (microdeletion testing) as investigational/non-covered. Update encounter forms to remind providers that multiple gestation pregnancies, microdeletions, and sex chromosome aneuploidy testing will be denied. Ensure genetic counseling documentation is included with all NIPT claims.