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Medicare Local Coverage Determination Policy PGx tests must demonstrate analytical validity, clinical validity, and clinical utility to be considered reasonable and necessary for coverage This is demonstrated through a required technical assessment of the test
How to Build a PGx Consultation Service as a Pharmacist Pharmacists don’t need a lab to offer PGx testing—there are already many labs that provide this service Look for PGx labs that: Some options include direct partnerships with PGx testing companies, working with providers who can order tests, or consulting with patients who bring in their own results
CMS Manual System - Centers for Medicare Medicaid Services Policy: In order that payment can be made for diagnostic tests, there are certain ordering requirements which must be met The requirements for both ordering and following orders for diagnostic tests are specified in this change request
PGX Testing Now Covered by NGS – Lab Revenue Navigator If your lab offers PGX testing and is in an NGS jurisdiction, the time to act is now We’re helping clients analyze policy, structure clinical documentation, and prepare for this July rollout
Implementing a Pharmacist-Led Primary Care Pharmacogenomics . . . The task force conducted a needs assessment to determine key stakeholder needs, which included: identifying which patients could benefit from PGx consult, which PGx labs to order, how to interpret and apply results, pharmacist education and training, and patient cost estimation
FAQs - Pharmacogenomics (PGx) - RxGenomix A signed order is required to process a test This can be approved by an MD, DO, nurse practitioner or physician’s assistant In some states, pharmacists may also order this and other tests