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The companies will work with labs to improve payors' understanding of the costs of performing PD-L1 testing and the value it provides to patient care.
As government lab spending grows, the Medicare contractor has barred access to a coding and pricing file obtained via FOIA claiming it holds business secrets.
The reimbursement rates for the most commonly performed SARS-CoV-2 serologic tests are $42.13 and $45.23, depending on the billing code used.
The new rate applies to clinical diagnostic lab tests using high-throughput technologies that can process more than 200 specimens per day.
The company had a challenging fiscal first quarter due to the deletion of CPT codes that payors used to use to reimburse hereditary cancer testing.
The health technology firm is proposing a new software solution that would standardize coding in genetic testing, but a more predictable system would also narrow variability in test pricing.
The agency said its aim is to analyze the way CMS has chosen to implement PAMA and to estimate the potential financial impact to Medicare as a result of those choices.
After a GAO report found that CMS may be overpaying for lab tests, the legislator is asking the government payor to explain how it will ensure appropriate use of taxpayer funds.
In a letter to CMS, AMP made a case for crosswalking existing CPT codes for BRCA1/2 testing to codes that more accurately reflect the work required to analyze these genes.
The firm has struggled in the past to convince payors of its test's clinical utility but remains dedicated to convincing the field that Epi proColon can help patients by closing CRC screening gaps.