So after a force sabbatical from the threads, I can finally post...

So after a force sabbatical from the threads, I can finally post up one of the more important finds to date. I could have shared this yesterday morning however was unable to for reasons I am sure all can understand.

PLA CODE

https://www.cms.gov/files/document/june-25-2024-clfs-public-meeting-agenda-v3.pdfI have located the meeting recording from Annie Bell who presented the reimbursement rate to CMS back in June.

Rewatch Here:

https://cms.zoomgov.com/rec/share/2jQakqNnZtNNToCNxJxnc62trzrWzmBar60OC5y2zhNgK256MZ3GQODzGyUv23UD.Quqt-jAZ5LoO8lH_

Password: v$Rf7#3J

Screenshots:


Lumos is was seeking to crosswalk the 87811 test reimbursement rate to LDX Febridx test rate of $41.38.Under crosswalking, an existing test or combination of tests with similar methodology and resources is used as a basis for the payment amount. Gapfilling is used when there is no other test with similar methodology and resources. In this case, MACs develop a payment amount for the test.



The above screenshot from the sourced CMS funding recommendation (on the CMS site I provided last week, different area) confirmed they will proceed as proposed and CMS agrees with the panel recommendation.

For reference, LDX completely knew the time frame for the PLA code reimbursement rate would be assigned/confirmed in December the entire time and Pauls comments were completely misguided:



Make of that what you will.