26B-3-134. Coverage of exome sequence testing.
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Effective 5/3/2023
26B-3-134. Coverage of exome sequence testing.
(1)As used in this section, "exome sequence testing" means a genomic technique for sequencing the genome of an individual for diagnostic purposes.
(2)The Medicaid program shall reimburse for exome sequence testing:
(a)for an enrollee who:
(i)is younger than 21 years old; and
(ii)who remains undiagnosed after exhausting all other appropriate diagnostic-related tests;
(b)performed by a nationally recognized provider with significant experience in exome sequence testing;
(c)that is medically necessary; and
(d)at a rate set by the Medicaid program.
Renumbered and Amended by Chapter 306 , 2023 General Session