USA PLA Code6 Oct 2023 08:32
The assignment of the PLA Code by the AMA represented a significant step in enhancing the accessibility and use of the PSE test across the US healthcare sector as part of a standardised billing mechanism across all healthcare providers, ensuring precise reimbursement and amplifying patient access to the test by simplifying the reimbursement process and reducing administrative burdens.
“A unique code is critical to the reimbursement process,” said chief operating officer Thomas Guiel.
“With the code issued at this early stage of the test introduction, we are in a good place to drive adoption of this highly accurate test.
“Effective on 1 January for all requests for insurance reimbursement, whether from Medicare, Medicaid or private payors, this unique code will enable discussions regarding coverage decisions as well as negotiating the reimbursement rate.”
Oxford said the new PLA code was officially published on 29 September and would be active for billing by payors from 1 January.
In the interim, a miscellaneous code for high-complexity molecular testing would be employed for reimbursement.