Several regional Medicare contractors have yet to set payments for new molecular diagnostic tests for 2013 and those that have done so have acted in an opaque manner, the American Clinical Laboratory Association wrote in a March 27 letter to CMS. ACLA says Medicare contractors have until April 1 to submit to CMS the rates they have calculated for more than 100 new molecular diagnostic codes. CMS announced in November that the codes, which represent tests that were previously paid via an imprecise “stacked” coding approach employed by laboratories, would be incorporated into the clinical laboratory fee schedule this year and that individual Medicare contractors would be tasked with setting payment rates in their regions under the Medicare “gap-filling” process. (See Also see "CMS In Brief" - Medtech Insight, 12 November, 2012..)
But ACLA’s letter cites “major problems with how gap-filling is proceeding,” noting that there is confusion over how contractors arrived...
