Lumos Diagnostics Holdings Ltd (ASX:LDX, OTC:LDXHF) has achieved full Medicare reimbursement recognition for FebriDx®, securing linkage to the US Clinical Lab Fee Schedule (CLFS) across all seven Medicare Administrative Contractors (MACs) — a milestone that strengthens its commercial pathway in the world’s largest healthcare market.
The final piece came from National Government Services (NGS), which manages Medicare payments across Illinois, Minnesota, Wisconsin, and the New England and New York regions. NGS’s decision means FebriDx is now reimbursed at US$41.38 per test nationwide, covering 100% of Medicare’s payment geography.
Map of US MAC Jurisdictions.
FebriDx® is a rapid, point-of-care finger-prick test designed to help clinicians differentiate between bacterial and viral respiratory infections within minutes — a tool Lumos has been working to scale in the US through targeted commercial partnerships. Yesterday, the company announced a new collaboration with AcuityMD to sharpen its go-to-market strategy, reflecting Lumos’ continued push to build US adoption.
Read more: Lumos Diagnostics tightens US commercial focus with AcuityMD collaboration
Focus shifts to formal policy and broader payor coverage
With all seven MACs now formally recognising FebriDx®, Lumos’ attention turns to supporting each contractor as they develop written reimbursement policy. These policies are essential for establishing consistent, efficient claims processing and giving providers greater clarity on coverage rules.
Lumos’ US commercial partner PRO-spectus will play a key role in these next steps, assisting both MACs and private payors to embed Medicare coverage into their internal reimbursement frameworks.
Read more: Lumos partners with PRO-spectus to accelerate commercial adoption of FebriDx® in the US
While Medicare accounts for roughly 20%–24% of the US payor mix, full recognition is expected to carry influence well beyond the federal program. Medicare Advantage (MA) and Medicaid plans frequently reference CMS fee schedules when setting their own pricing and coverage expectations, and Lumos expects the momentum to accelerate integration across these channels.
Milestone unlocks broader US adoption
Managing director Doug Ward said the reimbursement recognition represents a turning point for the company.
“Securing reimbursement from all seven MACs is a landmark achievement for Lumos and helps position FebriDx for broad adoption across the US healthcare system,” Ward said.
“Full Medicare recognition not only unlocks access across all regions but also paves the way for wider uptake through Medicare Advantage, Medicaid and private payors,” he added. “We look forward to working closely with our partners to support the integration of this coverage and ensure FebriDx reaches the clinicians and patients who will benefit most.”
The reimbursement milestone follows a series of US-focused updates from Lumos in recent months, including progress on commercial pilots and expanded collaboration efforts aimed at improving US market penetration.
Read more: Building momentum: Strong quarter underpins Lumos Diagnostics’ US rollout plans
Lumos develops and commercialises rapid point-of-care diagnostic technologies, including its own branded tests and digital reader platforms, alongside tailored assay development and manufacturing services for healthcare customers globally.