CMS Issues Proposed Decision Memo on Reconsidered Next Generation Sequencing National Coverage Determination

CMS issues a proposed decision memo that would revise and expand on the coverage for next generation sequencing (NGS) as a diagnostic laboratory test for ovarian and breast cancer when selected criteria are met. The proposed decision memo would revise the current Medicare national coverage determination (NCD) – originally adopted on March 16, 2018 – in regards to NGS testing of germline (inherited) gene mutations for patients with advanced cancer. CMS would give the local contractors discretion as to whether to cover NGS testing for other indications.

Comments on the proposed decision memo are due to CMS by November 28, 2019.

Proposed Decision Memo for Next Generation Sequencing (NGS) for Medicare Beneficiaries with Advanced Cancer