Personalis wins Medicare coverage; $3,878 MRD and $1,158 plasma
Personalis (PSNL) announced that its ultrasensitive NeXT Personal tests received Medicare coverage for post‑treatment surveillance of cancer recurrence in stage II and III breast cancer.
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Rhea-AI Filing Summary
Personalis (PSNL) announced that its ultrasensitive NeXT Personal tests received Medicare coverage for post‑treatment surveillance of cancer recurrence in stage II and III breast cancer. The determination from the Centers for Medicare & Medicaid Services Molecular Diagnostics Program is effective retroactively as of October 7, 2025.
The NeXT Personal Dx Breast MRD Recurrence Monitoring Test is covered at a reimbursement rate of $3,878 and is available once per cancer diagnosis. The NeXT Personal Single Plasma Test is covered at $1,158 and is available for up to six years post‑treatment. This expands access and establishes defined payment levels for these assays among eligible Medicare patients.
Positive
- Medicare coverage granted for NeXT Personal assays with defined rates: $3,878 (Dx Breast MRD, once per diagnosis) and $1,158 (Single Plasma, up to six years post‑treatment).
Negative
- None.
Insights
Medicare coverage sets clear payment and access for PSNL’s tests.
Personalis secured Medicare coverage for its NeXT Personal assays used to monitor recurrence in stage II/III breast cancer. The decision is effective retroactively as of October 7, 2025, providing defined payments of $3,878 for the Dx Breast MRD Recurrence Monitoring Test and $1,158 for the Single Plasma Test.
Coverage mechanics matter: the Single Plasma Test is available for up to six years post‑treatment, while the Dx Breast MRD test is available once per cancer diagnosis. These parameters shape potential test utilization and revenue per patient under Medicare.
Financial impact will depend on test adoption among eligible beneficiaries and ordering patterns under these coverage limits. Subsequent disclosures may quantify volumes and revenue contributions following the October 2025 effective date.
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FAQ
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What did Personalis (PSNL) announce?
What are the Medicare reimbursement rates for PSNL’s tests?
How long is the Single Plasma Test covered for Medicare patients?
How often is the Dx Breast MRD test covered?
Which patients are covered under this decision?
Who issued the coverage determination?
AI-generated analysis. How Rhea-AI works. Not financial advice.