Biovica: CMS has issued a preliminary Clinical Laboratory Fee Schedule (CLFS) payment decision for DiviTum TKa to pursue the gap-fill process during 2024 - Redeye

The gap-fill process will allow Biovica to secure a Medicare (CMS) code and a preliminary price as of early 2024. We can expect the final Medicare price decision in October 2024, which may divert somewhat from the initial (Medicare) preliminary price. Compared with the faster cross-walk decision, this path reduces the risk of a low final DiviTum price, will result in a higher price during 2024 and will also make it even more important to secure additional direct bill contracts establishing a high reference price level during 2024. During 2024, Biovica will be able to sell via three US channels: Medicare, Direct Bill and negotiated private insurance channels.

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