Thursday, April 7, 2016

MolDX Announces Expansion to WPS MAC

On April 6, 2016, MolDX updated its FAQ of general questions.  They've added WPS to the list of MACs following the program (Medicare MACs J5, J8).

See here.   Quoting:
3. What laboratories will be affected?All private, reference, and hospital laboratories that perform molecular diagnostic testing and submit claims to Medicare in JE, JF JM, J15 J5, or J8 on a CMS 1500 Claim Form or electronic claims on a 5010-837P are affected by this program. (Please reference the specific jurisdiction MDT policy for effective dates.)
5. Is the MolDX Program national in scope?The MolDX Program currently covers JE (CA, NV, HI), JF (WA, OR, ID, MT, WY, AZ, ND, ND, HI, UT, Aleutian Islands), JM (NC, SC, VA, WV), J15 (TN, OH), J5 (IA, MO, KS, NE) and J8 (MI, IN). Labs that perform services for patients in those states, must register in order to submit a Medicare claim.
10. Will the MolDX Program expand to other jurisdictions?At this time CMS has not determined how MolDX will be expanded. Palmetto GBA will continue to administer active LCDs and articles published in JM, Noridian will administer the MolDX in JE and JF, CGS will administer MolDX in J15, and WPS will administer MolDX in J5 and J8.

Implementation details don't seem to be up on the WPS website yet.
By my count, MolDX now provides diagnostics policy and pricing to 24 states and 44% of the Medicare population.