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Presumptive and definitive drug testing

December 1, 2014

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Effective January 1, 2015, AmeriHealth will implement a new medical policy related to coverage of both presumptive and definitive drug testing. Coverage for presumptive and definitive drug testing will be subject to specific medical necessity criteria and frequency limits identified in the medical policy.

To review our position on presumptive and definitive drug testing, refer to the Policy Notifications available on our Medical Policy Portal after December 1, 2014. Select Accept and Go to Medical Policy Online, and then select the Commercial or Medicare Advantage tab from the top of the page, depending on the version of the Notification you'd like to view. Then type the policy name or number in the Search field:

  • Commercial: #06.02.44: Presumptive and Definitive Drug Testing
  • Medicare Advantage: #MA06.025: Presumptive and Definitive Drug Testing
You can also view policy activity through the NaviNet® web portal by selecting the Reference Tools transaction, then Medical Policy.

If you have any questions related to this new medical policy, please contact your Network Coordinator or Hospital/Ancillary Services Coordinator.

NaviNet® is a registered trademark of NaviNet, Inc.

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