Veracyte Bladder Cancer Test Receives Medicare Coverage

Under the determination from Medicare Administrative Contractor Palmetto GBA, molecular diagnostic tests for use in a patient with bladder cancer will be covered when the patient is actively being managed for bladder cancer; is within the population and has the indication for which the test was developed and is covered; and is a candidate for multiple potential treatments with varied or increasing levels of intensity based on a consensus guideline or is a candidate for multiple therapies, where the test has shown it predicts response to a specific therapy.

The test must demonstrate analytical validity, and, if based on an algorithm, the algorithm must be validated in a cohort that isn’t a development cohort for the algorithm. It must also demonstrate clinical validity and utility and complete a Molecular Diagnostic Program technical assessment.

Fellow MACs CGS Administrators and Wisconsin Physicians Service Insurance Corporation have aligned their coverage with Palmetto’s. The LCDs will go into effect on July 18.

Source: https://www.genomeweb.com/reimbursement-news/veracyte-bladder-cancer-test-receives-medicare-coverage