The Comments Are In: Stakeholders Categorize Genomic Tests

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This is the third white paper in a series documenting Medicare’s efforts to begin using 100-­-plus new CPT codes for molecular diagnostic tests. The codes were approved by the AMA CPT editorial panel in October 2010 and February 2011, allowing publication in October 2011 for use on January 1, 2012.

The first white paper, “Tempest in the Melting Pot: Genomics Reimbursement 2012,” appeared in November 2011 and described Medicare’s decision to defer use of the CPT codes until 2013. The second white paper, “Tempest Continues: Fee Schedules in Collision,” appeared in July 2012 and described Medicare’s dilemma, by then already a year old, in assigning the genetic codes to the clinical laboratory or the physician fee schedule. This third white paper, appearing in September 2012, discusses the broad range of stakeholder comments received by CMS. These public comments will inform the decision that CMS will announce in the first week of November, 2012.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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