For US Healthcare Professionals OnlyDistributors
*Calculated using 2017 insured lives; 2018 and 2019 census data not yet published.
Since 2016, the percentage of insured patients who are eligible for reimbursement for FeNO testing has risen from 57% to 79%. As of July 2019, over 234 million Americans have access to FeNO testing, including those on Medicare and Medicaid.1
2019 Medicaid Coverage
60+ million Medicaid lives are covered for FeNO testing in the US.4 43 States in the US include CPT 95012 on their Physician Fee Schedule, covering and reimbursing for FeNO monitoring.
Average reimbursement rates for FeNO tests can vary from insurance company to insurance company and from state to state. Commercial insurance, on average, reimburses $26 per FeNO test, federally-funded insurance reimburses $21 per test, and state-funded insurance reimburses $15 per test.
References: 1. Data on file. Circassia Pharmaceuticals Inc. April 2019 2. 2018 Payer Sheet. Data on File. Circassia Pharmaceuticals Inc. April 2018 3. CMS Medicare Fee Schedule (state reimbursement rate fluctuates based on regional Medicare contracts) https://www.cms.gov/apps/physician-fee-schedule/license-agreement.aspx. Accessed October 3, 2019. 4. State Medicaid Fee Schedule (reimbursement rate fluctuates based on MCO contracts) https://www.cms.gov/apps/physician-fee-schedule/license-agreement.aspx. Accessed October 3, 2019.