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CMS Will Not Reimburse for Multi-Analyte Algorithm-Based Diagnostic Tests

The Centers for Medicare and Medicaid Services intends to deny reimbursement for the algorithmic analysis underlying multi-analyte tests, its stands has developers of molecular diagnostics and genetic tests worried, according to Genome Web.

CMS said these multi-analyte algorithm-based assays, or MAAAs, do not fit the agency's definition of laboratory diagnostics. The tests use mathematic formulas to analyze markers associated with risk for disease and are considered "boutique" tests.

CMS said Medicare uses codes for payment of the underlying clinical tests and wants to continue not separately pricing MAAAs codes.

Currently, MAAAs are not listed in tiers 1 or 2 of the CPT codes list created by the American Medical Association, thought the AMA said it will grant CPT codes for MAAAs that it has reviewed and deemed valid.

More Articles on Coding, Billing and Collections:
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