Blog Posts by Date: Mar 2013


Palmetto Says New MoPath Reimbursement Rates Will Be Posted April 1

  • March 30, 2013

Palmetto asked CCLA to aggregate data required for palmetto to perform a true gap fill analysis. CCLA members plus some additional molecular labs provided data to Palmetto over the last three weeks. Due to the limited timeframes, only the highest volume molecular tests were the subject of the exercise (EGFR, KRAS, BRAF, CYP2C9, CYP2C19, CYP2D6)....

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Chart Illustrates Efforts by CMS to Commoditize Molecular Diagnostic Testing

  • March 22, 2013

The following chart helps to demonstrate how fees under the Palmetto Tier 1 and Tier 2 molecular fee schedules stack up against average fees under stacked coding for the higher volume tests.  The trend clearly shows a push to move the price point for most genetic testing services below $200 and commoditize diverse and high complexity...

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Time to Voice Concerns Over Medicare MoPath Reimbursement

  • March 20, 2013

Labs are actively petitioning both federal, state, and city representatives to voice their concerns over the drastic slash in reimbursement that has accompanied the new molecular pathology fee schedules released by Medicare Contractors. Councilmember Lorie Zapf of the City of San Diego has written CMS regarding her “concerns related to the process...

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Effects of MoPath on Net Revenue for Labs

  • March 5, 2013

The release of the new MoPath codes by several Medicare Contractors have triggered a flood of analysis regarding the impact of the new prices on net revenue for labs doing molecular diagnostic testing. Early impact analysis shows that labs could be reimbursed 25-50% less under the new Molecular Pathology coding method when compared to...

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New Lower MoPath Prices Threaten Labs and Patient Access to Valuable Tests

  • March 4, 2013

The laboratory industry lobbied hard and successfully for placement of the new molecular pathology codes on the CLFS. The arguments were compelling. In hindsight, based on the pricing we have seen this week we have to ask ourselves if we may not have been better off with what the RUC proposed for the 77 codes that they priced. Laboratories may do...

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