New Pricing Formula for Advanced Diagnostic Tests

New law defines ADTs and directs CMS to use HCPCS codes and list prices for these new lab tests

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CEO SUMMARY: One section of the federal H.R. 4302: Protecting Access to Medicare Act of 2014 is getting positive reviews from many lab experts. The law defines advanced diagnostic tests (ADTs) and directs CMS to assign a temporary HCPCS code and use list prices to pay labs for such tests while it is determining reimbursement guidelines. However, because few labs perform ADTs, this section of the law affects only a handful of lab companies performing sole-source lab tests.

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