Replies to post #160327 on Biotech Values

[DewDiligence]

Medicare reimbursement for molecular diagnostics:

http://www.forbes.com/sites/scottgottlieb/2013/05/22/medicare-nixes-coverage-for-some-new-cancer-tests/

The new payment system has cut payment rates across the board, by an average of about 20% (and as high as 80% in some cases) from 2012 levels. Most of the new rates are being based on the work of one Medicare contractor, Palmetto GBA.

Hardest hit by the change, however, are many new diagnostic tests that aren’t yet a part of routine medical practice or may only benefit a small patient group, often with rare disease states. These diagnostics are being dubbed “tier 2” tests since they weren’t assigned discrete “codes” under the AMA’s new coding scheme.

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