Medtech Insight is part of Informa PLC

This site is operated by a business or businesses owned by Informa PLC and all copyright resides with them. Informa PLC’s registered office is 5 Howick Place, London SW1P 1WG. Registered in England and Wales. Number 8860726.

This copy is for your personal, non-commercial use. For high-quality copies or electronic reprints for distribution to colleagues or customers, please call +44 (0) 20 3377 3183

Printed By

UsernamePublicRestriction
UsernamePublicRestriction

With Genetic Test Codes Developed, CMS Undecided On How To Pay For Them

This article was originally published in The Gray Sheet

Executive Summary

Specific reimbursement codes have been developed for the first time for more than 100 genetic tests, but they will not be adopted by Medicare until at least 2013 as CMS figures out how to incorporate them into the payment system.

You may also be interested in...



Molecular Dx Labs Fret Over Medicare Payment Setting, Or, In Some Cases, Lack Thereof

The industry’s angst is growing several months after CMS announced a plan to task contractors with independently setting regional payments for more than 100 new molecular diagnostic codes. A breakdown in the process so far, stakeholders say, could have a lasting impact on small, venture-backed labs.

CMS Signals Clinical Lab Fee Approach For Molecular Test Codes

The agency did not make any final decisions in a recent proposal tied to its annual clinical lab fee setting process, but CMS gave a sense that at least some of the 101 newly created genetic test codes would be paid for under the lab fee schedule, rather than the physician fee schedule, using the “gap-fill” process.

CMS Signals Clinical Lab Fee Approach For Molecular Test Codes

The agency did not make any final decisions in a recent proposal tied to its annual clinical lab fee setting process, but CMS gave a sense that at least some of the 101 newly created genetic test codes would be paid for under the lab fee schedule, rather than the physician fee schedule, using the “gap-fill” process.

Related Content

Topics

UsernamePublicRestriction

Register

OM002409

Ask The Analyst

Ask the Analyst is free for subscribers.  Submit your question and one of our analysts will be in touch.

Your question has been successfully sent to the email address below and we will get back as soon as possible. my@email.address.

All fields are required.

Please make sure all fields are completed.

Please make sure you have filled out all fields

Please make sure you have filled out all fields

Please enter a valid e-mail address

Please enter a valid Phone Number

Ask your question to our analysts

Cancel