CMS to Determine New Payment Rates for Tumor Cell Testing

The Centers for Medicare and Medicaid Services are prepping to determine payment rates for two new Current Procedural Technology codes for circulating tumor cell testing, according to the Sacramento Bee.

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The only CTC test approved by the FDA is the Veridex CELLSEARCH test for metastatic breast, colorectal and prostate cancer patients. This test was already assigned temporary codes by the American Medical Association, and now the AMA has approved new Category I CPT codes for the administration of the test and the professional interpretation of results.

CMS will now hold an open meeting to discuss the payment rate for the CTC test. The determination will be made on or before Nov. 1 and implemented by Jan. 1, 2013.

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