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Under a proposed rule, devices given FDA's breakthrough designation would, upon receiving FDA market authorization, immediately be covered by Medicare.
Saying pooled testing for coronavirus was not for diagnostic purposes, Cigna had said it wouldn't reimburse for the method, but it plans to change its policy.
The organization had previously only recommended the use of noninvasive prenatal testing in individuals 35 and older or with other known risk factors.
The report noted that savings from the lower payment rates were offset by increased spending on other tests, including genetic tests.
Issued this week, the proposed fee schedule would cut overall pathology service payments by 9 percent compared to 2020 and independent lab services by 5 percent.
In a local coverage article, Medicare contractors in the MolDx program added prostate cancer to the covered indications for the test.
The classifiers are considered reasonable and necessary if the patient can tolerate chemotherapy and it's being considered as a treatment for the patient.
The MAC will consider PGx testing reasonable and necessary after a physician has narrowed a patient's treatment options to specific medications.
A bi-weekly listing of recent local coverage determinations from Medicare Administrative Contractors.
Under the LCD, pharmacogenomic tests are covered when medications are being considered for use that are known to have a clinically actionable gene-drug interaction.
The decision comes after Myriad requested expanded coverage for women with breast cancer seeking information about extending endocrine therapy.
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.
Noridian is also developing a generic policy for donor-derived cfDNA tests that will include several commercially available tests, Natera said.
The Medicare Administrative Contractor's decision covers molecular diagnostic laboratory tests as predictive classifiers for non-small cell lung cancer.
The PCR tests are being requested more often during the SARS-CoV-2 pandemic to rule out patients with other viral respiratory conditions.
The new rate applies to clinical diagnostic lab tests using high-throughput technologies that can process more than 200 specimens per day.
Under the guidance, group health plans and group and individual health insurers must cover diagnostic testing and other "certain related items and services."
The diagnostic will be covered when patients are tested according to the Japanese Organization of Hereditary Breast and Ovarian Cancer's criteria.
The lawsuit also alleges Anthem failed to delete inaccurate diagnosis codes, leading to inflated risk-adjustment payments from Medicare.