Effective Nov. 1, 2021 for Medicaid and Health and Recovery Plan (HARP) members, coverage of non-invasive prenatal trisomy screening using cell-free fetal DNA (deoxyribonucleic acid) will be expanded to include pregnant members age 30 and older. Additionally, this coverage now includes twin pregnancies, but not higher multi-gestational pregnancies. Consistent with current policy, non-invasive prenatal trisomy screening will continue to be covered when at least one of the following criteria is met:
- Either parent has a family history of aneuploidy in a 1st* or 2nd** degree relative.
- Standard serum screening or fetal ultrasonographic findings indicate an increased risk of aneuploidy.
- Parent(s) have a history of a previous pregnancy with a trisomy.
- Either parent is known to have a Robertsonian translocation.
* 1st degree relatives: Parents, children, siblings
** 2nd degree relatives: Grandparents, aunts and uncles, nieces and nephews, and grandchildren
For more information, including six reminders, providers can refer to the August 2021 issue of New York State Medicaid Update.
Note: This is an update to the October 2014 Medicaid Update article titled NYS Medicaid Now Covers Non-invasive Prenatal Testing for Trisomy 21, 18 and 13.
JP #56547 12/2021
