Oncologists will soon be able to submit claims to payers using a Category III CPT code, paving the way for wider adoption of precision treatment options.
— Dr. Razelle Kuzrock, Co-Founder and Chief Medical Advisor of CureMatch
SAN DIEGO, CA, USA, January 4, 2023 /EINPresswire.com/ — CureMatch, Inc., a leader in precision medicine support for oncology, is pleased to announce that the American Medical Association (AMA) has issued the new Current Procedural Terminology (CPT®) Category III code 0794T for the therapy matching and scoring service CureMatch offers (“Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patient’s tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and reported separately”). The AMA published this code on January 1, 2023, and it will be effective July 1, 2023, which will allow oncologists to track the use of CureMatch’s groundbreaking therapy matching system and submit for reimbursement.
The AMA issues and manages CPT codes, which are widely used by government payers, including Medicare and Medicaid, along with commercial health plans to identify healthcare services and procedures that may be eligible for reimbursement. CPT Category III codes are designed to track and facilitate the use, adoption, and eventual reimbursement for emerging technologies. CureMatch is grateful to the CPT Editorial Panel for recognizing the importance of these innovative support tools that analyze enormous amounts of information so that physicians can make the best treatment decisions with their patients.
“As a practicing oncologist, I know how crucial it is for physicians to have the tools they need to prescribe the right cancer treatments the first time,” said Dr. Razelle Kurzrock, Co-Founder and Chief Medical Advisor of CureMatch. “Achieving this CPT code is a significant milestone for our company and for the field of precision oncology, and we are grateful to the AMA for this designation. Physicians who submit claims using this code will be part of the solution, paving the way for wider adoption and availability of precision medicine treatment options for cancer patients.”
No two cancers are the same, and each case is as unique as an individual patient’s genetic makeup. The growing field of precision medicine makes it possible for oncologists to genetically sequence a patient’s tumor and treat their cancer with a combination of drugs tailored to their unique cancer. But despite the availability of these testing options, a small percentage of cancer patients are currently benefiting from truly personalized treatment options. Not only do physicians not have the time to assess which of the millions of possible customized combinations best match a patient’s unique molecular profile, but it is beyond human cognition to process millions of possible combinations. Meanwhile, a significant proportion of cancer patients are not receiving the optimal treatment combination, developing resistance to certain drugs over the course of their treatment and suffering from debilitating side effects as their disease progresses.
CureMatch solves the key piece of this challenge using a proprietary curated knowledge base and an artificial intelligence platform to quantify and qualify therapy options based on each patient’s molecular data. A 2019 I-PREDICT clinical study published in Nature (as well as other published studies) show that 75% of patients treated using combination therapies with higher molecular matching scores had significantly improved progression-free survival (PFS).
During a five-year period starting on July 1, 2023, oncologists and other providers will be able to submit claims to payers for the use of the CureMatch therapy matching solution by applying this unique CPT code (0794T) indicating the need and demand for this precision oncology tool.
“Historically, a major obstacle to the use of precision cancer treatment was the amount of data it involved,” said Navid Alipour, CEO of CureMatch. “The CureMatch System allows oncologists to easily sort through mountains of research and use their knowledge to recommend the best possible treatment combinations for their patients. We are thankful for the opportunity to demonstrate the need and interest among physicians for this powerful tool through this new CPT code.”
CureMatch is a leader in precision medicine. Created on the belief that oncologists everywhere should benefit from world-class research, CureMatch uses a proprietary curated knowledge base within a unique analytical platform to solve the therapeutic complexity and match the best therapy options to the unique molecular makeup of a patient’s tumor. www.CureMatch.com