Oxford BioDynamics (OBD) has received a reimbursement code for its EpiSwitch Prostate Screening (PSE) Test. The PSE test boosts the predictive accuracy of the standard PSA test from 55% to 94% for determining the presence or absence of prostate cancer. The CPT PLA Code 0433U has been issued to OBD for insurance reimbursement under Medicare, Medicaid, and private payors. The code will be available for use from 1 January 2024. The issuance of the code less than 3 months after filing demonstrates the importance of the PSE test for screening and the recognition by payor groups. The unique code aids the billing process and simplifies reimbursement for healthcare providers, ensuring greater access to the test for patients.
The PSE Test was launched ahead of schedule on September 26 and is immediately available to men in the US and UK being screened for prostate cancer. The test was launched as a Laboratory Developed Test (LDT) to provide immediate access for men with clinical concerns about prostate cancer and to generate clinical utilization for the test. OBD's management believes that the speed of issuance of the CPT code demonstrates the recognition of the importance of the PSE test for screening and the potential savings to the medical industry.
Thomas Guiel, OBD's Chief Operating Officer, stated, "A unique code is critical to the reimbursement process. With the code issued at this early stage of the test introduction, we are in a good place to drive adoption of this highly accurate test." The unique code will enable discussions regarding coverage decisions and negotiating the reimbursement rate with insurance providers.
OBD's flagship products are the EpiSwitch CiRT (Checkpoint Inhibitor Response Test) and EpiSwitch PSE (EpiSwitch Prostate Screening test) blood tests. The CiRT test is a predictive immune response profile for immuno-oncology checkpoint inhibitor treatments, while the PSE test boosts the predictive accuracy of the PSA test for prostate cancer screening. OBD also launched its first commercial prognostic test, the EpiSwitch CST (Covid Severity Test), in March 2021.