MedCity News June 18, 2024
Jason Bush and Sarah Bretz

Health plans should be sure the following elements are incorporated into their genetic testing benefits framework.

As health plans struggle to cope with the rapid growth in genetic testing, they’re finding that their programs for routine test management are not up to the task.

An estimated 180,000 genetic tests are on the market, with an average of 10 new tests added daily. CPT coding has yet to keep up. Only about 500 CPT codes are used for 360 times the number of tests. The resulting system is slow, inefficient, expensive, and prone to waste, fraud, and abuse. Health plans need management programs designed specifically for genetic testing, which will only grow in volume and complexity.

Whether designing their program or...

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Topics: Insurance, Payer, Pharma / Biotech, Precision Medicine, Provider
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