Myriad Gentics Reports in 8-K Filing that CPT Code Pricing Error Should Take a 'Week or Two' to Correct

On September 30, 2013 the Centers for Medicare & Medicaid Services (CMS) released finalized pricing for the new molecular pathology codes for 2014 and beyond. As expected, CPT code 81211 (BRCA1 & BRCA2 full sequence) and CPT code 81213 (BART large rearrangements) were priced at $2,795.09 and $587.12 respectively, which was identical to the initial median pricing submitted by the Medicare Administrative Contractors. This will be the finalized Medicare pricing reflected in the 2014 Clinical Laboratory Fee Schedule. CMS also posted the molecular pathology codes for the remaining three months of 2013. Unfortunately, Noridian Healthcare Solutions LLC (the Medicare contractor for Utah) and Palmetto GBA made a clerical error in their pricing for CPT code 81211 (BRCA1 & BRCA2 full sequence). This error was confirmed by Myriad in a telephone call to both Noridian and Palmetto this afternoon. During the call, Noridian informed Myriad that it will contact CMS and immediately correct the pricing for CPT code 81211 to $2,795.09. We believe that it may take a week or two for this correction to be reflected by CMS.