Noridian Aligns with Palmetto on Single-Gene, Multi-Gene PGx Test Coverage

Medicare Administrative Contractor Noridian Healthcare Solutions aligned its coverage decision with Palmetto GBA’s recently announced limited coverage determination for single-gene and multi-gene pharmacogenomics tests. 

Under Noridian’s final local coverage determination, the tests are considered reasonable and necessary after a treating physician has narrowed a patient’s treatment options to specific medications, or if the patient is already using specified medications known to have clinically actionable gene-drug interactions as defined by the US Food and Drug Administration or the Clinical Pharmacogenetic Implementation Consortium. The LCD applies to services performed on or after Aug. 17. 

Source: https://www.genomeweb.com/reimbursement-news/noridian-aligns-palmetto-single-gene-multi-gene-pgx-test-coverage