ArticleGenetics in medicine : official journal of the American College of Medical Genetics2017
Utilization of genetic tests: analysis of gene-specific billing in Medicare claims data.
Article in Genetics in medicine : official journal of the American College of Medical Genetics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clinical Outcomes of Molecular Tumor Boards: A Systematic Review.JCO precision oncology · 2021Pooled it
- Clinical utility and costs of inpatient hereditary thrombophilia testing following acute VTE: A 5-Year retrospective study.Journal of thrombosis and thrombolysis · 2026Observational
- Disparities in tissue-based biomarker testing among US Medicare beneficiaries with prostate cancer.JNCI cancer spectrum · 2025Article
- A National Study Among Diverse US Populations of Exposure to Prescription Medications with Evidence-Based Pharmacogenomic Information.Clinical pharmacology and therapeutics · 2025Article
- Characterizing trends in clinical genetic testing: A single-center analysis of EHR data from 1.8 million patients over two decades.American journal of human genetics · 2025Article
- A randomized controlled trial of analogue pharmacogenomic testing feedback for psychotropic medications.PEC innovation · 2023Article
- Hospital-level variation in genetic testing in children's hospitals' neonatal intensive care units from 2016 to 2021.Genetics in medicine : official journal of the American College of Medical Genetics · 2023Article
- Analyzing Precision Medicine Utilization with Real-World Data: A Scoping Review.Journal of personalized medicine · 2022Article
- Molecular Tumor Board Review and Improved Overall Survival in Non-Small-Cell Lung Cancer.JCO precision oncology · 2021Article
- Novel Approach Using Administrative Claims to Evaluate Trends in Oncology Multigene Panel Testing for Patients Enrolled in Medicare Advantage Health Plans.JCO precision oncology · 2021Article
- The regulatory landscape of precision oncology laboratory medicine in the United States - Perspective on the past 5 years and considerations for future regulation.Practical laboratory medicine · 2020Article
- Genetic testing utilization for patients with neurologic disease and the limitations of claims data.Neurology. Genetics · 2020Article
- Clinical Molecular Marker Testing Data Capture to Promote Precision Medicine Research Within the Cancer Research Network.JCO clinical cancer informatics · 2019Article
- Trends in BRCA Test Utilization in an Integrated Health System, 2005-2015.Journal of the National Cancer Institute · 2019Article
- Preemptive pharmacogenetic testing: exploring the knowledge and perspectives of US payers.Genetics in medicine : official journal of the American College of Medical Genetics · 2019Article
- Utilization of Genetic Testing for RET Mutations in Patients with Medullary Thyroid Carcinoma: a Single-Center Experience.Journal of genetic counseling · 2018Article
- Standardization can accelerate the adoption of pharmacogenomics: current status and the path forward.Pharmacogenomics · 2018Review
- From public health genomics to precision public health: a 20-year journey.Genetics in medicine : official journal of the American College of Medical Genetics · 2018Review
- Genetic Test Availability And Spending: Where Are We Now? Where Are We Going?Health affairs (Project Hope) · 2018Article
- Trends in utilization and costs of BRCA testing among women aged 18-64 years in the United States, 2003-2014.Genetics in medicine : official journal of the American College of Medical Genetics · 2018Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe examined the utilization of precision medicine tests among Medicare beneficiaries through analysis of gene-specific tier 1 and 2 billing codes developed by the American Medical Association in 2012.
methodsWe conducted a retrospective cross-sectional study. The primary source of data was 2013 Medicare 100% fee-for-service claims. We identified claims billed for each laboratory test, the number of patients tested, expenditures, and the diagnostic codes indicated for testing. We analyzed variations in testing by patient demographics and region of the country.
resultsPharmacogenetic tests were billed most frequently, accounting for 48% of the expenditures for new codes. The most common indications for testing were breast cancer, long-term use of medications, and disorders of lipid metabolism. There was underutilization of guideline-recommended tumor mutation tests (e.g., epidermal growth factor receptor) and substantial overutilization of a test discouraged by guidelines (methylenetetrahydrofolate reductase). Methodology-based tier 2 codes represented 15% of all claims billed with the new codes. The highest rate of testing per beneficiary was in Mississippi and the lowest rate was in Alaska.
conclusionsGene-specific billing codes significantly improved our ability to conduct population-level research of precision medicine. Analysis of these data in conjunction with clinical records should be conducted to validate findings.Genet Med advance online publication 26 January 2017.
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