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The DXRX marketplace, planned for launch in the fourth quarter of 2020, will provide a way for pharmaceutical companies, diagnostic firms, and laboratories to collaborate.
A bi-weekly listing of recent local coverage determinations from Medicare Administrative Contractors.
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 changes include who can order tests for beneficiaries, who can bill CMS for certain testing-related services, and the inclusion of antibody tests as a covered service.
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.
A lack of specificity in CMS guidelines combined with increased FDA scrutiny of LDTs could make it more difficult for labs to make changes to existing assays.
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 lawsuit also alleges Anthem failed to delete inaccurate diagnosis codes, leading to inflated risk-adjustment payments from Medicare.