On October 30, I wrote a blog that AMA CPT had added a long series of new comprehensive genomic profiling (CGP) codes for 2024,and that CMS had proposed to price them all at about $600.
The topic is highlighted in a deep dive article by Kelsy Ketchum at 360Dx, one of the Genomeweb-family trade journals. Find it here (Subscription):
SALSA, the legislative PAMA reform act, would cap price changes at 5% up or down. If CMS misprices a test (or if scant data leads to super high or super low PAMA pricing), the fixed priced could only migrate by 5% a year. For example, if SALSA rules were enacted, if CMS priced these tests at $595 and PAMA prices came in at $4500, the tests would only move up by $15 or so ($610) per year. (It would take about 35 years at 5% per year to reach from $595 to $3300).