Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment – Revised 9/24/2020 MM11937

Advanced Diagnostic Laboratory Tests (ADLTs)

Code 0090U – myPath Melanoma Effective September 6, 2019, CMS approved laboratory test myPath MelanomaTM, currently described by HCPCS code 0090U, as a new Advanced Diagnostic Laboratory Test (ADLT). The new ADLT initial period for myPath MelanomaTM is effective for dates of service beginning on or after October 1, 2019 through June 30, 2020. During the new ADLT initial period, payment for myPath MelanomaTM shall be made at actual list charge in the amount of $1,950, as described in the list of approved ADLTs, available at the following CLFS link: https://www.cms.gov/files/document/advanced-diagnostic-laboratory-tests-undermedicare-clfs.pdf. For dates of service beginning on or after July 1, 2020 through December 31, 2021, the payment rate for myPath MelanomaTM shall be equal to the weighted median of private payor rates established under the payment methodology described in 42 C.F.R. § 414.507(b) and in the amount of $1,755.

Coronavirus-19 (COVID-19) Policy Updates

Code Effective September 8, 2020 The listed new code will be added to the national HCPCS file with an effective date of September 8, 2020 and does not need to be manually added to the HCPCS files by the MACs. However, the new code is contractor-priced (where applicable) until it is nationally priced and undergoes the CLFS annual payment determination process in accordance with the Social Security Act § 1833(h)(8), § 1834A(c) and § 1834(A)(f). • Code: 86413 • Long Descriptor: Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (Coronavirus disease [COVID-19]) antibody,quantitative • Short Descriptor: SARS-COV-2 ANTB QUANTITATIVE • TOS: 5

CR Transmittal Number: R10367CP

Source: https://www.cms.gov/files/document/mm11937.pdf