Navigating the Clinical and Financial Complexities of MRD Testing
Minimal Residual Disease (MRD) testing is rapidly expanding across emerging applications and disease areas, offering powerful insights to guide treatment decisions and monitor disease progression. However, for many laboratories, the path from innovation to reimbursement is far from straightforward.
Unlike more established molecular tests, MRD lacks standardization across billing models, coding strategies, and payor coverage policies. Laboratories must navigate critical decisions—such as bundled vs. non-bundled billing approaches, PLA vs. CPT coding, and evolving prior authorization and documentation requirements—often without clear or consistent reimbursement outcomes.
This session will explore the real-world complexities of operationalizing and monetizing MRD testing. Drawing on payer data, reimbursement trends, and practical lab experience, we will examine where laboratories encounter the greatest financial risk—and how leading organizations are adapting their strategies to improve payment predictability and reduce revenue leakage.
Attendees will gain a deeper understanding of how Market Access, Commercial, and Revenue Cycle teams must align to support MRD adoption, along with practical approaches to navigating inconsistent payor behavior, reducing denials, and optimizing reimbursement performance. The session will also highlight how advanced analytics and automation can be applied to monitor payor trends, prioritize workflows, and strengthen financial outcomes in an increasingly complex reimbursement environment.
Key Takeaways
- Understand the real reimbursement landscape for MRD testing, including why payment outcomes vary across labs, payors, and testing models
- Learn how to evaluate billing and coding strategies—PLA vs. CPT and bundled vs. non-bundled approaches—and their impact on coverage, denials, and revenue predictability
- Identify the primary drivers of MRD denials, including medical necessity, documentation gaps, and prior authorization requirements—and how leading labs are addressing them
- Gain practical insight into how Market Access, Commercial, and RCM teams must align to support MRD adoption and improve financial performance
- Explore how leading laboratories are using data, analytics, and automation to monitor payor behavior, reduce revenue leakage, and strengthen reimbursement outcomes
Presenters
Clarisa Blattner
Senior Director, Revenue and Payor Optimization
XiFin, Inc.
Heather Agostenlli
Vice President and Head of Specialty RCM
XiFin, Inc.
Jennfier Lemons
Director, Diagnostic Policy Fulfillment
XiFin, Inc.