CMS Signals Clinical Lab Fee Approach For Molecular Test Codes
This article was originally published in The Gray Sheet
Executive Summary
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.
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Industry Groups Push CMS To Pay For Algorithms In Multi-Analyte Tests
The agency’s proposal not to separately pay for the algorithmic analysis that forms the basis of many multi-analyte molecular diagnostic tests misconstrues the nature of the tests, industry groups argue. They call for a final determination by CMS that more truly reflects the value of these assays.
Industry Groups Push CMS To Pay For Algorithms In Multi-Analyte Tests
The agency’s proposal not to separately pay for the algorithmic analysis that forms the basis of many multi-analyte molecular diagnostic tests misconstrues the nature of the tests, industry groups argue. They call for a final determination by CMS that more truly reflects the value of these assays.