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CMS Has Largest-Ever Public Meeting – Discusses Pricing Lab Test Codes

On June 22, 2020, CMS held its largest-ever annual public meeting for pricing new laboratory test codes. In addition, it was the first-ever meeting held only virtually. Nearly 30 different organizations offered comments on some 130 new codes. 

A full transcript of the meeting is available at the blog Discoveries in Health Policy. The blog’s author, Bruce Quinn MD PhD, told XIFIN there are several distinctive features of this year’s meeting.

 “Many stakeholders wanted to comment on permanent fee schedule pricing of the new codes related to COVID testing,” said Dr. Quinn. “All of these stakeholders wanted pricing of high-capacity COVID testing to remain in the $100 range currently used by CMS.”

 “In addition, most new codes were Proprietary Laboratory Analysis, or PLA codes. 88 codes were PLA codes. New drug assay codes were also popular, with a dozen new codes (for example, for methotrexate and for amiodaorone). In the field of genetics, new PLA codes were proposed for RNA sequencing, which may reduce the number of variants of unknown significance.”

CMS will also hold an expert advisory panel meeting to discuss these same 130 codes on July 29/30. CMS will release proposed pricing for public comment around September 1.


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Published by XIFIN
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