Coverage + Billing

CPT Codes

Myriad Brand CPT Code
EndoPredict® Breast Cancer 81522
Prolaris® Prostate Cancer 81541
CPT PLA Code
GeneSight® Psychotropic 0345U*
myChoice® CDx FDA-Approved Targeted Therapies 0172U
*Code effective October 1, 2022. Publication by the American Medical Association CPT Editorial Panel January 1, 2023.

Medicare Coverage by Brand

  • EndoPredict® Breast Cancer

    Medicare Coverage

    “Medicare […] will provide limited coverage for the EndoPredict breast cancer gene expression test for the management of post-menopausal women diagnosed with early-stage (TNM stage T1-3, N0-1) estrogen-receptor (ER) positive, Her2-negative breast cancer, who are either lymph node-negative or who have 1-3 positive nodes, and for whom treatment with adjuvant endocrine therapy (e.g., tamoxifen or aromatase inhibitors) is being considered.”

    MolDX: EndoPredict Breast Cancer Gene Expression Test (37311), effective date 1/30/2018.

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  • GeneSight® Mental Health

    Favorable technical assessment by MolDX

    Local Coverage Determination (LCD): MolDX: Pharmacogenomics Testing (L38394)

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    Local Coverage Article (LCA): Billing and Coding – MolDX: Pharmacogenomic Testing (A58324)

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  • Prolaris® Prostate Cancer

    Covered by Medicare

    Prolaris® Prostate Cancer Genomic Assay

    • L36350: LCD for NCCN very low- and low-risk
    • L37082: LCD for NCCN favorable intermediate-risk

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Laboratory Accreditations

From state licenses to ISO Accreditation, Myriad has several clinical laboratory certifications. You can find them here:

View Lab Accreditations

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