The American College of Medical Genetics and Genomics (ACMG) recommends informing all pregnant people that NIPT is the most sensitive screening option for traditionally screened aneuploidies 13, 18 and 21 for a continuum of gestational age beginning at 9–10 weeks². The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal Fetal Medicine (SMFM) have also recommended: "cfDNA screening for common aneuploidies (trisomies 21, 18, and 13) be made routinely available to all obstetrical patients as the most sensitive and specific screening test for common fetal aneuploidies in any patient population. After pretest counseling, every patient has the right to pursue tor decline prenatal genetic screening and diagnostic testing.³

Depending on the location of your practice and access to health plans, please consult with your insurance plan administrators on whether your patient is eligible for NIPT coverage.

Private payer reimbursement rates and CMS (Centers for Medicare & Medicaid Services) CLFS (Clinical Laboratory Fee Schedule) rates often differ because they are established through different contracting and pricing mechanisms. Private payers negotiate rates individually with laboratories based on market dynamics, while CLFS rates are set by CMS using a weighted median of periodically reported private payer payments under the Protecting Access to Medicare Act (PAMA). 

Since the beginning of NIPT development, over 60 publications have been generated and published by clinical and technical experts and medical societies. To help you and your colleagues make a decision more easily, we have summarized the currently available studies, guidelines, and bibliography in the clinical dossier that you can download and review.

For more information on NIPT reimbursement, please email us at medinfo@illumina.com.