Medicare Covers Veracyte Prosigna Breast Cancer Test

The genomic test provides breast cancer recurrence risk scores for eligible postmenopausal women.

Updated on Oct. 16, 2026 in Cancer

Isometric editorial illustration featuring a glass petri dish with organic tissue, symbolizing genomic health testing in a clinical environment. — Medicare has expanded national access to the Prosigna genomic test, allowing oncologists to tailor breast cancer treatment based on recurrence risk. AI Illustration. Upload story photo >

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Medicare began covering the Prosigna breast cancer recurrence test on August 19, 2026, through the MolDX program. The decision expands national access to the genomic test for postmenopausal patients with early-stage, ER+ breast cancer.

Why it matters

The coverage allows oncologists to better utilize tumor biology data to tailor treatment plans for patients. By identifying risk levels, the test assists providers in determining whether patients can safely avoid chemotherapy.

The Prosigna test assesses cancer recurrence risk over a 10-year period for patients with stage I or II disease and 0-3 positive lymph nodes. Data from the OPTIMA trial previously indicated that two-thirds of similar patients were spared chemotherapy.

The players

Veracyte

This global diagnostics company specializes in genomic testing for various cancers and is headquartered in South San Francisco.

MolDX

This program, managed by Palmetto GBA, evaluates molecular diagnostic tests to determine if they meet clinical criteria for Medicare coverage.

The details

Veracyte secured this coverage after submitting a comprehensive Technical Assessment to Palmetto GBA. The test analyzes tumor biology alongside clinical and pathological factors to generate a personalized risk assessment for patients in the United States.

June 2026: The Prosigna test launched in the United States.
August 19, 2026: Medicare reimbursement coverage became effective.
October 16, 2026: Veracyte publicly announced the reimbursement decision.

The Big Picture

The inclusion of the Prosigna test within the MolDX program follows a broader shift toward integrating molecular diagnostics into standard clinical practice. This decision aligns with the ongoing trend of using genomic data to refine treatment protocols within the Medicare system.

Eligible postmenopausal women can now access this test with Medicare coverage to help determine if chemotherapy is medically necessary. Patients should consult with their oncologists to determine if their specific early-stage, ER+ cancer profile qualifies for the test.

The takeaway

Genomic testing continues to play an increasing role in personalizing cancer care and reducing unnecessary treatments. Patients diagnosed with early-stage breast cancer should discuss the potential benefits of risk-of-recurrence testing with their healthcare providers.