WGS Elevance Coverage Softens Potential Genome vs. Exome Air Pocket

Research evidence excerpt

WGS Elevance Coverage Softens Potential Genome vs. Exome Air Pocket

C O M PA N Y N O T E

J u n e 2 2 , 2 0 2 6

GeneDx Holdings Corp. (WGS) Overweight

CONCLUSION PRICE: US$55.42

We view Carelon’s new outpatient genome coverage policy as a potential structural ASP TARGET: US$63.00

de-risking event for GeneDx (WGS). By codifying genome sequencing as a first-line option, Our $63PT is based on a ~4x multiple on a 2Y

the policy facilitates payment for the inevitable exome-to-genome mix shift. While this shift fwd. EV/Sales multiple, with $171M in cash and

resulted in a Q1 revenue shortfall and a short-term headwind, we believe the updated cash equivalents, and $168M in debt, and 30M

policy could drive ~$100 in incremental ASP by H2 2027. While we remain conservative shares outstanding.

on the immediate payment realization, this policy meaningfully softens the "air pocket" of

David Westenberg, CFAreimbursement uncertainty that pressured Q1 results. We remain OW and raise our PT to Sr. Research Analyst, Piper Sandler & Co.

$63 (from $50). 727 281-6589, david.westenberg@psc.com

Karan Patel

• What is Carelon? Carelon Medical Benefits Management (formerly AIM Specialty Research Analyst, Piper Sandler & Co.

Health) is a specialty benefits management company owned by Elevance Health. They 727 709-9084, karan.patel@psc.com

act as the "gatekeeper" for complex, high-cost clinical services. They set the Clinical Skye Gilbert

Appropriateness Guidelines that determine whether a test is "medically necessary." Research Analyst, Piper Sandler & Co.

646 357-0308, skye.gilbert@psc.com

When Carelon updates a guideline, it dictates the reimbursement behavior for the entire

Elevance footprint (Anthem, BCBS plans, Amerigroup, etc.). Changes Previous Current

Rating — Overweight