Correction: Retroactive Rate Adjustment for Breast Cancer Testing

Effective retroactively for dates of service on or after January 1, 2014, the rate for CPT code 81211 (BRCA1, BRCA2 [breast cancer 1 and 2]; gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1) is increased. The rate for CPT code 81211 when billed with modifier QP remains unchanged. Modifier QP should be used with a single ordering test or when a single code is available for grouping of tests, such as automated profile codes 80002-80019, G0058, G0059 and G0060. An Erroneous Payment Correction will be issued, allowing automatic resubmission of claims with dates of service on or after January 1, 2014. No action is required of Medi-Cal providers.