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Payment

AdvaMedDx seeks payment reform and Medicare fee schedule modernization that recognizes the full contribution of modern diagnostics to health care quality and outcomes. Reimbursement challenges can dampen the incentive for new test development. Furthermore, increased insurer demands for direct evidence of a test’s impact on patient outcomes, cumbersome coding regimes, and rate setting approaches that disregard test value create difficult hurdles for new test developers and slow patient access to promising tests that can inform personalized medicine approaches.

AdvaMedDx advocates for the appropriate payment of diagnostics:

  • Update the archaic and flawed clinical laboratory fee schedule. 
  • Medicare reimbursement rates should be based on today's advanced technologies and the value of these diagnostics as they relate to patient care and management. 
  • Payment rates should take into account the impact of diagnostic tests on patient care and the technical characteristics of tests, including resources needed to develop, validate and perform them.