Coverage of exome sequence testing.

1. Law
2. Utah Code
3. Utah Health Code
4. Medical Assistance Act
5. Medical Assistance Programs
6. 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 of age; 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.

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