CMS Signals Clinical Lab Fee Approach For Molecular Test Codes
The agency did not make any final decisions in a recent proposal tied to its annual clinical lab fee setting process, but CMS gave a sense that at least some of the 101 newly created genetic test codes would be paid for under the lab fee schedule, rather than the physician fee schedule, using the “gap-fill” process.
CMS provided some insight into its reimbursement plans for 101 new molecular diagnostic test codes in Sept. 1 draft recommendations, but questions remain.
The agency is the middle of a process to determine the proper home for the new codes, which represent a...