PGx America Genetic Testing and Adverse Drug Reactions A Simple Test that SAVES LIVES

Predicting All Adverse Drug Reactions Bringing Personalized Medicine

& Revenue To Your Practice

Do You Get Paid Extra To Take A Temperature?Would you like to get paid Extra just for weighing your patients? How

about more money just to take their blood pressure? Update their meds list?

You do those things everyday as part of your job, with every patient because they are the best predictors of present or future problems. However, everyday you are failing to do one more little thing that is as simple as swabbing a cheek. This simple swab can save more lives and sniff out more medical time bombs than all of those routine movements combined. And for this, you actually do get paid extra.

Pharmacogenomics is a very long word for a very simple procedure, so we call it PGx. A 40 second PGx swab is a profoundly effective way for you to save lives while greatly enhancing the scope and revenue of your practice.

CMS Guidance Is ClearMedicaid will pay you to administer this test to the 40% of your patients (on average) that you see each day fitting any of these 3 simple criteria:

- 5 or more daily meds of any kind - 4 meds including a Cardio, Psych or Pain med - 1 Cardio, Psych or Pain med with symptoms of Adverse Drug Reaction

Depending on the nature of the practice, patient and payer, you can expect to be reimbursed for your brief efforts from $25 to $150 for this essential Diagnostic. Later we will show specific payment scenarios for different insurers. If you are seeing 20 patients a day and are not testing 8 of them on average, many are leaving your office at risk.

Possible area fee schedule

4

Insurance Company 99385 99386 99387 99395 99396 99397 99401 99402 99403

G0452 Must

Append Modifier 26 G0446

Aetna $ 75.00 $ 80.00 $ 85.00 $ 55.00 $ 60.00 $ 65.00 BR BR BR N/A N/AOxford $ 70.65 $ 80.75 $ 85.00 $ 56.75 $ 60.85 $ 67.30 BR BR BR N/A N/A

United $ 85.60 $ 90.85 $ 93.75 $ 56.75 $ 60.85 $ 67.30 BR BR BR N/A N/AMedicare N/A N/A N/A N/A N/A N/A N/A N/A N/A $ 18.26 $ 29.30 Medicaid NY 64.87 75.73 75.73 54.77 59.95 66.86 Included included included N/A N/A

Informational only: Fee schedules and determination vary from area to area, state to state, depending on, type of coverage, area of coverage and individual policies.      

BR= BY REPORT NA- NOT APPLICABLE

G2 : Molecular pathology procedure; physician interpretation and reportG0446 : Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes

Insurance Company 99385 99386 99387 99395 99396 99397 99401 99402 99403

G0452 Must Append

Modifier 26 G0446

Aetna $ 75.00 $ 80.00 $ 85.00 $ 55.00 $ 60.00 $ 65.00 BR BR BR N/A N/A

Oxford $ 70.65 $ 80.75 $ 85.00 $ 56.75 $ 60.85 $ 67.30 BR BR BR N/A N/A

United $ 85.60 $ 90.85 $ 93.75 $ 56.75 $ 60.85 $ 67.30 BR BR BR N/A N/A

Medicare N/A N/A N/A N/A N/A N/A N/A N/A N/A $ 18.26 $ 29.30

Medicaid NY 64.87 75.73 75.73 54.77 59.95 66.86 Included included included N/A N/A

Informational only: Fee schedules and determination vary from area to area, state to state, depending on, type of coverage, area of coverage and individual policies.      

BR= BY REPORT NA- NOT APPLICABLE

G0452 : Molecular pathology procedure; physician interpretation and report

G0446 : Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes

The Only Investment Required Is Concern PGx America will have a Plug-n-Play system instilled into your regular office

visits within a week. No software or hardware needs mastered. Our experts personally train your staff from triage to billing. Physician’s time involved should be less than 1 minute per patient.

- If the tests are not helpful, you are doing it wrong - If it is taking too much time, you are doing it wrong - If you are not getting paid, you are doing it wrong Let us do the work. We get it right.

The Many PGx Benefits to Your PracticeWithin weeks your practice will be at the sharpest edge of 21st Century,

Personalized Medicine and all practice marketing should reflect that. Many practices refer to themselves as “PGx Clinics” to attract targeted clientele.

Increased scope of medicine, consultations Nursing, coding and charting expertise to make it easy on staff Access & experience to polypharmacy and genetic counseling makes

you the expert Revenue

PGx Brings value to any practice todayTomorrow it will be strandard practice