The group recommended a $76.97 payment rate, which it determined by applying a 1.5 multiplier to the Zika virus testing fee, MedTechDive reported Aug. 23. The group said the rate accounts for extra resources including personal protective equipment and the use of a Biosafety Level-3 facility.
Medicare administrative contractors Novitas and First Coast Services Options set reimbursement rates at $51.31, and Noridian set its rate at $35.09, the report said.
“Both of these rates … do not account for the inputs required to run a monkeypox test,” the ACLA said in a letter to CMS. “This raises significant concerns that an inadequate payment rate may impact patient access to testing for a pathogen that is currently declared a public health emergency in the United States.”
The group is urging CMS to direct MACs to pay claims for monkeypox testing at the ACLA recommended rate to facilitate testing capacity and patient access, the report said.
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