MolDX Manual December 2015

• JE A/B MAC, which covers California, Nevada, Hawaii and the US Pacific Territories of Guam, American Samoa and the Northern Marianas, administered by Noridian Healthcare Solutions
• JF A/B MAC, which covers Oregon, Washington, Idaho, Montana, Wyoming, Nevada, Arizona, North Dakota, South Dakota, Alaska, and the Aleutian Islands, administered by Noridian Healthcare Solutions
• JM A/B MAC, which covers North Carolina, South Carolina, Virginia, and West Virginia, administered by Palmetto GBA
• J15 A/B MAC, which covers Ohio and Kentucky, administered by CGS Administrators, LLC  

The objective of this document is to describe the process that Palmetto GBA (Palmetto GBA) uses to determine coverage, coding, and pricing for molecular diagnostic tests and other molecular pathology services administered through the Molecular Diagnostic Services (MolDX) Program.