Several Medicare Administrative Contractors (MACs) in the last two weeks have increased pricing for eight molecular pathology codes that industry sources said were initially priced significantly below cost. Palmetto GBA, the MAC for California, Nevada, Hawaii, and the U.S. Pacific territories, was the first to announce that it was increasing pricing for the codes, which include BRAF, KRAS, EGFR, CYP2C9, CYP2C19, CYP2D6, JAK2, and F5. Cigna Government Services and National Heritage Insurance Corp. soon followed. The revised pricing is based largely on information submitted by the California Clinical Laboratory Association, which had argued that the initial MAC payment rates were too low for labs to continue performing some critical molecular diagnostic tests. The pricing increase ranged from 9 percent for CPT code 81275 (KRAS) to 189 percent for CPT 81226 (CYP2D6). National Government Services also updated fees in mid-April, but they matched the original pricing released by Palmetto, according to Kyle Fetter, assistant vice president, molecular diagnostics services, XIFIN Inc., which helped coordinate the lab data submitted to Palmetto. “This would appear to be a timing issue, and we still expect to see Medicare contractors come into line with Palmetto’s new pricing,” he wrote in a blog posting at www.xifin.com. “While it’s heartening to see these prices trending upward, even these updated prices are below where they need to be.” Analysts from Piper Jaffray note that with two MACs following Palmetto’s lead, it has cemented its place as the leader in the field. Sustained lobbying pressure by industry groups is having an effect on pricing, the analysts add. “We continue to believe this will culminate in 2014 MolDx codes (Tier 1) being higher than their 2013 counterparts,” they wrote in an April 19 industry note.