logo
PROVIDERS
LABS
CROs
PAYORS
PATIENTS
ABOUT US
Schedule a Demo
Contact Us
scope image
Overview

Secure Reimbursement for Your Lab’s PGx Testing

Leverage streamlined billing workflows, recognized CPT codes, and proven best practices to ensure financial success in precision diagnostics.
Schedule a Demo Contact us
Overview
In an era where precision medicine is redefining healthcare, laboratories need clear, reliable pathways to receive reimbursement for pharmacogenomic (PGx) testing. PGxAI helps labs navigate the complexities of coding, documentation, and payor requirements—maximizing revenue and minimizing denials. By aligning lab workflows with established CPT codes, our solution ensures your advanced PGx services translate into stable, sustainable income.
•
CPT Code Alignment: Consistent, recognized billing methods for pharmacogenomic tests and related services
•
Payor Collaboration: Insights into public and private insurer guidelines to support coverage decisions
•
Success Stories: Real-world examples of labs achieving high approval rates and robust ROI
Key Features
Serving every stakeholder in healthcare
Schedule a Demo Contact Us
1
icon
Standardized Coding
Pharmacogenomics-Related CPT Codes: PGxAI supports the identification of relevant codes in the 81200-813XX range, ensuring accurate claim submissions.
Documentation Made Easy: Auto-generated reports and required information for smooth billing cycles.
2
icon
Evidence-Based Documentation
Clinical Utility: PGxAI provides clear, data-backed rationale (e.g., targeted gene-drug interactions) to strengthen claims.
Audit-Ready: Our platform maintains logs of all analyses, preserving a transparent record for payors and regulators.
3
icon
Integrated Billing Workflow
LIMS & Financial Systems: Automate the handoff from test completion to claim creation.
Minimized Denials: Reduce errors from manual data entry and ensure accurate coding through built-in checks.
Case Study
Genex Labs
Schedule a Demo Contact Us
icon
Challenge
High denial rates for PGx tests, leading to patient dissatisfaction and lost revenue.
icon
Solution
Implemented PGxAI’s billing workflow and utilized CPT codes recommended by our reimbursement specialists.
icon
Results
85% approval rate on submitted claims within six months, substantially increasing revenue and patient satisfaction.
Case Study
Healthcare Organizations That Implement PGxAI Often Report
Schedule a Demo Contact Us
Improved Revenue Cycle
Enhanced claims acceptance rates translate into consistent, predictable income for your PGx services.
Lower Administrative Burden
Automated coding and reporting features streamline your lab’s billing processes, saving staff time and resources.
Expanded Client Base
Confidently market your PGx panels to physician offices and health systems, supported by transparent reimbursement workflows.
Built-In Compliance
HIPAA, SOC 2 adherence, plus the supporting documentation for third-party payors, ensures you meet all regulatory obligations.
Payor Collaborations
Seamless EHR Integration
Leverage streamlined billing workflows, recognized CPT codes, and proven best practices to ensure financial success in precision diagnostics.
icon
Private Insurers
Guidance on negotiated rates and coverage rules, drawing on experience with major insurance carriers.
icon
Government Programs
Keep abreast of Medicare/Medicaid updates, ensuring alignment with the latest CMS guidelines.
icon
Ongoing Education
Access materials and webinars on changes to CPT codes, new payor policies, and emerging best practices.
Whats next
Ready to Secure Reimbursement for Your PGx Services?
Contact Our Reimbursement Specialists
Get personalized guidance on payor strategies and best-in-class documentation.
icon
Request a Demo
See how PGxAI’s coding and billing tools integrate with your LIMS.
icon
Learn More
Explore our success stories and best practices to elevate your lab’s revenue cycle today.
icon