Medicare Mandates 100% Coverage for Lung Cancer Biomarker Testing Starting 2027

If you’ve ever had a loved one navigate a serious illness, you know the diagnosis is only the first hurdle. The next is figuring out how to pay for the advanced testing that leads to the best treatment. The Lung Cancer Medicare Access to Precise Testing Act is designed to clear that hurdle for one specific, critical area: lung cancer.

This bill amends the Social Security Act to require Medicare to cover lung cancer biomarker testing starting January 1, 2027 (Sec. 2). What exactly is that? Think of it as personalized medicine. Instead of just knowing someone has lung cancer, this testing analyzes the patient’s tissue, blood, or other fluids to identify specific biomarkers—tiny genetic or molecular signposts (Sec. 2). Knowing these markers allows doctors to select highly targeted therapies, often leading to better outcomes than traditional chemo. Essentially, it helps match the right drug to the right tumor.

The Cost of Precision: 100% Coverage

The biggest win for patients here is the payment structure. The bill amends Section 1833(a)(1) of the Social Security Act to state that Medicare will pay 100 percent of the reasonable charges for this lung cancer biomarker testing. This is a game-changer for Medicare beneficiaries diagnosed with lung cancer. Currently, even covered services often come with deductibles, co-pays, or co-insurance, which can add up fast when dealing with complex diagnostics. By mandating 100% coverage, the bill effectively eliminates the patient’s out-of-pocket cost for this specific, high-value test.

What This Means for Everyday Life

For a 68-year-old on a fixed income facing a lung cancer diagnosis, this provision means immediate access to state-of-the-art diagnostic testing without worrying about a massive bill hitting their mailbox. Precision medicine is expensive, and this testing is often the prerequisite for accessing life-extending targeted therapies. Removing the cost barrier ensures that treatment decisions are driven by the best available science, not by a patient’s ability to pay a few thousand dollars in co-insurance for the diagnostic workup.

The Bigger Picture: Costs and Implementation

While this is clearly a massive benefit for patients, there are two key groups that will bear the cost: the Medicare program itself and, by extension, taxpayers. Mandating 100% coverage for a specific, advanced test means Medicare’s expenditures will increase beginning in 2027. The bill uses the term “reasonable charges,” which will need clear benchmarking to ensure that the laboratories providing this testing don't inflate prices, knowing Medicare is required to pay the full amount. However, the intent is clear: prioritize access to life-saving diagnostic information for a vulnerable patient population, ensuring that the latest advancements in cancer care are available to those who need them most.