COVERAGE

Medicare Coverage: NGS Testing of Early-Stage Cancer Patients Is Back in Play

The reimbursement outlook for those who provide next generation sequencing (NGS) testing to early-stage cancer of Medicare patients with hereditary risks is far brighter today than it was a few weeks … [Read more...]

BILLING & CODING

Medicare Reimbursement: CMS Begins Implementing New HOPPS Date of Service Rules for ADLTs & Molecular Pathology Tests

CMS has begun implementing the new rules that exempt advanced diagnostic laboratory tests (ADLTs) and molecular pathology tests from Medicare Hospital Outpatient Prospective Payment System (HOPPS) … [Read more...]

FOCUS ON

Emerging Tests: Medicare to Cover Next Gen-Sequencing Tests for Advanced Cancer

In the PAMA era, there are two salient trends in Medicare Part B lab reimbursements: Sharply lower prices for traditional tests; and Wider coverage of newly emerging tests, including some that … [Read more...]

COVERAGE

Emerging Tests: Medicare to Cover Next Gen-Sequencing Tests for Advanced Cancer

In the PAMA era, there are two salient trends in Medicare Part B lab reimbursements: Sharply lower prices for traditional tests; and Wider coverage of newly emerging tests, including some that … [Read more...]

INDUSTRY BUZZ

Company of the Month: Interpace Diagnostics

Question: What do Parsippany, NJ-based Interpace Diagnostics and butter have in common? Answer: They're both on a roll. July 27: The molecular lab announces that Cigna will cover its ThyGenX … [Read more...]

MEDICARE COVERAGE

Reimbursement Trends: 8 Molecular Assays Score Big Coverage Wins from Medicare, Private Insurers

Molecular labs continue to gain ground with insurers. This summer, 8 more genetic assays received positive coverage decisions—4 from Medicare and 4 from private insurers. The winners included Genomic … [Read more...]

PRECISION MEDICINE

Medicare Reimbursement: 4 Molecular Assays Score Big Coverage Wins

Molecular labs continue to gain ground with Medicare securing four key approvals via finalization of Local Coverage Determinations (LCDs) issued by principal contractor Palmetto GBA this spring. All … [Read more...]

MOLECULAR TESTS

Palmetto Gives Okay to Medicare Coverage of 5 New Molecular Tests

Medicare contractors are slowly coming around on covering unproven molecular assays. The most notable new baby steps come from, Palmetto GBA (Columbia, SC), one of Medicare's most important … [Read more...]

BILLING & CODING

Reimbursement Trends: 5 More New Molecular Tests Get the Medicare Green Light from Palmetto

Normally among the slowest payors to accept promising but unproven new tests, Medicare continues to loosen the reins for molecular assays. In May, Palmetto GBA (Columbia, SC), one of Medicare's most … [Read more...]

REIMBURSEMENT

Update on Palmetto’s Molecular Dx Testing LCDs

Advanced diagnostic tests are emerging faster than the clinicians can document their clinical utility. All of this creates an interesting dilemma for payors as far as coverage is concerned. Normally … [Read more...]


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