Boston An independent LDT provider

Reimbursement overview in the US

February 17, 2021

Reimbursement in the US: An Overview
Presented by Karen Rego, MS, Sales Operations and Payer Relations Manager
Published February 17, 2021

0:19 Types of health insurance in the USA
1:30 Health insurance enrollment in the US, 2018
2:40 Components of reimbursement for a clinical test
3:36 Addressing Coding, Coverage, and Rate with a new test
4:53 Understanding coding categories
5:47 Criteria for new Current Procedural Technology (CPT) codes
6:46 Level of Evidence (LOE) required and application time
7:45 Key considerations for coverage introduction
8:01 Key considerations for coverage of a new test
9:48 Evidence: Analytical and Clinical Validity
11:03 Additional Coverage Drivers
11:25 Additional comments on US Guidelines
12:01 Which payers to target first for coverage
12:52 Summary