Designing Multiplex Panels for a Changing Reimbursement Landscape

The reimbursement landscape for molecular diagnostics is shifting, and it is beginning to influence more than billing. It is shaping how laboratories approach test design.

In particular, increased scrutiny around CPT 87798 and multiplex infectious disease testing is changing how multi-target assays are evaluated and reimbursed. Across Medicare and commercial payers, expectations are becoming more defined, placing new pressure on laboratories to align clinical value with reimbursement realities.

For many labs, the challenge is clear: how to maintain comprehensive testing capabilities while adapting to a more structured reimbursement environment.

What’s Changing in the Market

Recent payer activity points to a consistent direction:

• Greater scrutiny of broad, multi-target panels, especially in outpatient settings
• Multiplex assays increasingly evaluated as a single service rather than individual targets
• Preference for clearly defined, specific tests over flexible or unspecified approaches
• Continued variation across Medicare contractors and commercial plans

While policies vary, the trend is clear. Clarity, specificity, and clinical alignment are becoming central to reimbursement decisions.

How Test Design Is Evolving

These shifts are changing how laboratories structure their testing menus.

Many are making critical decisions on current larger multiplexed panels:

• Large, static panels with 20 or more targets
• One-size-fits-all testing strategies
• Open-ended or highly customized panel configurations

And toward:

• Smaller, syndrome-specific panels
• Clearly defined and consistently deployed assays
• Testing strategies that can adapt as coverage policies evolve

Test design is no longer just a clinical decision. It is an operational one that directly impacts sustainability.

A More Strategic Approach to Multiplex Design

The answer is not to reduce capability, but to apply flexibility with greater structure.

A more effective model combines a flexible multiplex foundation with clearly defined test offerings.

Structured Panels for Clarity

Using fixed, named panels such as Respiratory Core, Women’s Health Core, or STI Core supports consistency and aligns with how tests are evaluated by payers.

At the same time, maintaining flexibility at the platform level allows for:

• Rapid development of targeted panels
• Efficient updates as clinical needs change
• Faster response to evolving coverage expectations

This approach separates internal flexibility from external clarity.

Supporting an Adaptive Testing Strategy

With the right design approach, laboratories can:

• Focus core panels on the most clinically actionable targets
• Separate less common targets into distinct assays
• Adjust panel composition over time without changing platforms

This creates a testing strategy that is both clinically relevant and operationally sustainable.

Why This Matters Now

As market expectations continue to evolve, laboratories face increasing pressure to ensure that:

● Tests are clearly defined and clinically justified

● Panel size aligns with current coverage trends

● Testing menus can evolve without disrupting operations

Manufacturers play a key role by enabling flexibility without adding complexity.

Multiplex testing remains a powerful tool in infectious disease diagnostics. The opportunity now is to ensure that flexibility in technology translates into clarity and alignment in practice.

Designing for What’s Next

At Magnet Medical Systems, we help laboratories design multiplex panels that adapt to changing clinical needs and evolving business market expectations, while maintaining consistency, clarity, and performance.

Learn more about building a more adaptive multiplex testing strategy.

This content is for informational purposes only. Coding and billing decisions should be made by the laboratory in accordance with applicable payer policies and regulations.