Molecular Dx Labs Fret Over Medicare Payment Setting, Or, In Some Cases, Lack Thereof

The industry’s angst is growing several months after CMS announced a plan to task contractors with independently setting regional payments for more than 100 new molecular diagnostic codes. A breakdown in the process so far, stakeholders say, could have a lasting impact on small, venture-backed labs.

Laboratories that run molecular diagnostic tests are increasingly alarmed at what they describe as a lack of transparency in Medicare price setting and, in some cases, failure by Medicare contractors to pay labs for tests performed.

The industry’s angst is growing several months after CMS announced a plan to task contractors with independently setting regional payments...

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