Washington D.C., Nov. 26, 2024- The Centers for Medicare & Medicaid Services (CMS) released the Clinical Laboratory Fee Schedule (CLFS) 2025 Final Rate Determinations yesterday, unveiling that clinically critical codes for the reimbursement of Alzheimer neurological biomarker blood tests have been referred to the process known as “gapfill.” Earlier this year, the preliminary recommendation for coverage on these codes was $17, far less than the $130 which the Global Alzheimer’s Platform Foundation® (GAP) and many other Alzheimer’s advocates deemed appropriate. This decision means that throughout the next year, Medicare Administrative Contractors (MACs) will set their own local rates, which may expedite a more equitable reimbursement decision and an eventual final national rate.
John Dwyer, the President of GAP stated: “Yesterday, CMS released its thoughtful decision on how coverage will be decided for neurological blood biomarker tests that are central to high quality and readily accessible assessments of patient that may have Alzheimer’s, and while it is not an ideal outcome, we expect that the MACs will exercise sound judgement based on the scientific literature and reimburse for these tests at a rate that reflects their clinical importance. The Global Alzheimer’s Platform Foundation supports the future use of approved blood-biomarker tests to improve patient care and recognizes that the proposed reimbursement rate of $130 per test is critical to giving all Alzheimer patients access to high quality diagnostics as well as advancing research in the AD field for everyone.”
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For immediate release:
Contact: media@globalalzplatform.org
About the Global Alzheimer’s Platform (GAP) Foundation:
The nonprofit Global Alzheimer’s Platform Foundation was founded to speed the
delivery of Alzheimer’s treatments with a commitment to promoting diversity in clinical
research, as well as lowering the cost and duration of clinical trials to ensure that no
one is left behind. As part of its mission, GAP supports more than 100 clinical
research sites worldwide through study start-up and recruitment activities, promoting
diversity in research studies, and giving attention to the citizen scientists who make
research possible.