Medicare Liver Fibrosis Biomarker Coverage Starts August 10

Published August 9, 2026, ahead of a Medicare local coverage policy that becomes effective August 10.

A Medicare coverage change for certain noninvasive liver fibrosis biomarker tests takes effect tomorrow. The policy matters because it pays for a much narrower and more structured use than the phrase "blood test for fatty liver" might suggest.

The Centers for Medicare & Medicaid Services Medicare Coverage Database lists a MolDX local coverage determination for molecular or proteomic biomarker testing in metabolic dysfunction-associated steatotic liver disease, or MASLD, and metabolic dysfunction-associated steatohepatitis, or MASH. Its original effective date is August 10, 2026.

What the policy actually covers

The policy does not cover automatic screening for every adult with obesity, diabetes, abnormal liver enzymes, or suspected fatty liver. It says all coverage criteria must be met. In plain language, the pathway includes:

• An adult with clinical evidence of liver dysfunction compatible with MASLD or MASH under current professional guidelines
• A preliminary risk assessment using clinical information and ordinary laboratory testing that does not indicate low risk, with FIB-4 of at least 1.3 given as an example
• No liver stiffness imaging in the previous 12 months, or an indeterminate imaging result
• A documented plan to use the result for a pending management decision, such as specialist referral, liver biopsy, or treatment eligibility or monitoring
• No more than one covered test in a 12-month period, and no testing within 12 months of a definitive liver biopsy
• A test that has passed MolDX technical assessment and meets the policy's validation and performance requirements

Because this is a local coverage determination rather than a national coverage determination, the Medicare contractor, jurisdiction, exact test, and patient's documented clinical situation still matter. The CMS billing article also says specific tests judged to meet the policy can be checked through the DEX registry.

Where NASHnext fits

GENFIT, which licenses the underlying NIS4 technology to Labcorp, announced that Labcorp's NASHnext test is expected to receive Medicare reimbursement beginning August 10 for patients who meet coverage criteria. GENFIT lists a Clinical Laboratory Fee Schedule amount of approximately $252 per test.

That is the manufacturer's description of its product and reimbursement status. The CMS policy is the controlling source for the coverage framework. CMS also states that mentioning a biomarker in the policy does not by itself establish coverage for a specific test.

NASHnext is not a general wellness panel. GENFIT describes it as a laboratory-developed blood test intended to identify people with at-risk MASH by combining information about disease activity and fibrotic burden. The policy is designed for fibrosis assessment after an initial clinical and laboratory risk screen, not as a first test for anyone curious about liver health.

A standard liver panel is a different test

A routine liver function panel measures enzymes, proteins, and bilirubin, including ALT, AST, alkaline phosphatase, albumin, and total and direct bilirubin. Those values can reveal patterns of liver cell injury, bile-flow problems, or impaired protein production.

They do not make a standard hepatic panel equivalent to NASHnext or another molecular or proteomic fibrosis test. A liver panel cannot diagnose MASH or determine a fibrosis stage by itself. The new coverage policy specifically addresses validated biomarker tests used after ordinary clinical and laboratory risk assessment has already raised enough concern to justify the next step.

The useful takeaway

The change is meaningful because it creates a payment path for selected noninvasive fibrosis assessments before a liver biopsy is considered. It is not a broad Medicare benefit for routine fatty-liver screening, and it is not permission to skip the clinical pathway built into the coverage criteria.

The clean distinction is between three different jobs: routine blood work can surface possible liver dysfunction, a validated biomarker test can help assess fibrosis risk in a qualifying patient, and a clinician uses the full record to decide what happens next. Medicare coverage beginning August 10 applies to that middle step under defined conditions.

This article is editorial commentary and is not medical advice. It has not been reviewed by a physician and should not be used to make decisions about liver disease diagnosis, fibrosis testing, imaging, biopsy, treatment, Medicare eligibility, or testing frequency.