Tag: apf

Payers Using Two Approaches To Price Molecular, Genetic Tests

PRIVATE PAYERS AND MEDICARE contractors are taking divergent approaches to establishing coverage policies and setting prices for molecular and genetic tests. That’s what Kuo Bianchini Tong, MS, CEO of Quorum Consulting Inc., sees happening.

“One approach seeks to recognize the clinical utility and value of these tests with nuanced, more discreet coding and pricing,” he observed.

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House Bill Introduced to Address Rate-Setting for Molecular Tests

FEW PATHOLOGISTS OR CLINICAL laboratory directors would argue against revising the current Medicare payment policies for molecular and genetic tests. A bill proposed in Congress would do just that.

The process now in use by Medicare Administrative Contractors (MACs) is inefficient and opaque, according to pathologists and lab executives. The result is not many clinical labs

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