Market Trends

COVID-19 Fuels Massive & Sustainable Growth in Molecular Diagnostics

While it may be decimating demand for most lab tests, COVID-19 is driving incredible growth in molecular testing. The global market for molecular diagnostics will top $13 billion in 2020, about $5 … [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...]

REIMBURSEMENT TRENDS

Billing & Coding: Proposed New Molecular Pathology Crosswalk Codes for 2018

The newly proposed 2018 Clinical Laboratory Fee Schedule includes over 130 crosswalked CPT codes, including roughly 30 new codes for molecular pathology tests. New Crosswalked Molecular Pathology … [Read more...]

MEDICARE COVERAGE

“Applicable Labs”: The Fly in the PAMA Market-Based Pricing Ointment

The lab industry has no objection to basing Medicare payments for lab tests on the actual rates charged to payors in the private market. What has the industry so upset is how CMS has executed the … [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...]


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