BioCentury
ARTICLE | Politics & Policy

CMS to price molecular pathology tests as lab services

November 3, 2012 1:08 AM UTC

CMS is revising the way it reimburses molecular pathology tests, but it remains unclear whether suppliers will get more or less money from the agency. Beginning next year, CMS will determine the reimbursement rate for molecular pathology tests under the Clinical Laboratory Services Fee Schedule (CLFS), which covers clinical diagnostic laboratory tests.

Previously, CMS determined the rates under the Physician Fee Schedule, which covers services that require "physician work." CMS said molecular pathology tests should be reimbursed under CLFS because the "services do not ordinarily require interpretation by a physician to produce a meaningful result." The agency said it will create a new code under the Physician Fee Schedule for tests where physician interpretation is "medically necessary." ...