Molecular Pricing Improves on Average, But Many Tests Not Priced at All

Final 2013-2014 Medicare prices for many new molecular pathology (MoPath) codes published Sept. 30 average about 26 percent higher than the proposed (interim) rates released earlier this year, though the median improvement is just 6 percent. The Centers for Medicare and Medicaid Services (CMS) published prices for just 65 of the 114 new MoPath codes. According to the agency, only codes that are currently being paid by Medicare administrative contractors (MACs) are listed. Some codes listed in the May 9, 2013, posting are not currently shown because the service is no longer being paid by the MAC. CMS is allowing a 30-day reconsideration period on these final prices, so it is possible there could be additional changes when the agency announces final amounts for the 2014 Clinical Laboratory Fee Schedule later this year. For more on final molecular pricing and questions that remain, see Inside the Laboratory Industry beginning on page 4.