Reimbursement
The PLAC® Test is covered by Medicare at $48.62 and by a growing number of private payers. However, patients may be required to pay out-of-pocket - a small investment in their future health.
CPT® code: 83698.
Click here to find a current CMS Fee Schedule by State.
Managed Care News
- January 2009
The 2009 Medicare Medicare Clinical Laboratory Fee Schedule was published on 1/1/09 and the National Limitation Amount (NLA) for CPT code 83698 was raised from $47.43 to $49.56. - January 2009
Priority Health, with approximately 440,000 covered lives in Michigan, has published a positive coverage policy for Lp-PLA2 testing with the PLAC® Test. - December 2008
Highmark Blue Cross Blue Shield, HealthAmerica and Helth Assuracne of PA Reimbursement for the PLAC Test for Lp-PLA2 - October 2008
Medical Mutual of Ohio, the largest health plan in Ohio with approximately 3 million covered lives has confirmed that they do not consider Lp-PLA2 testing with the PLAC Test as an experimental service. - September 2008
CIGNA HealthCare, the 6th largest health plan in the country with over 9 million covered lives has established positive coverage for Lp-PLA2 testing with the PLAC Test effective August 15, 2008.
CPT is a copyright and registered trademark of the American Medical Association (AMA). Please consult with current CPT Manuals for full descriptors and instructions regarding the use of these codes.