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HPV Testing–Reimbursement: Cervical Cancer Screening

The Digene^® HPV Test* (DNAwithPap^® Test) is widely reimbursed by almost every plan in the US for ASC–US reflex testing, and rapid progress has been made to gain broad coverage for primary adjunctive screening. To date, over 225 million lives are covered for primary adjunctive screening across insurance plans nationwide. It is anticipated that coverage for this indication will soon be as broad as ASC–US reflex testing.

Covered Lives Chart

* The trademarks shown are owned by the respective insurance companies and do not indicate sponsorship or affiliation with Digene.

Recommendations from the American College of Obstetrics and Gynecology (ACOG), the American Cancer Society (ACS), and the Association of Reproductive Health Professionals (ARHP) state that women who have negative results with both the Pap and the HPV test are at virtually no risk of developing cervical disease or cancer for up to 3 years. However, there is currently no threat to reimbursement for annual exams and appropriate cervical cancer screening as determined by the provider. Payers support the annual visit and will continue to pay for it whether or not a Pap is performed. Additionally, in the vast majority of cases, the rate for an annual visit is not impacted by whether or not a Pap is performed.

Payers support cervical cancer screening practice and decision–making in accordance with recently published evidence based guidelines. Defining an appropriate screening interval for your own patients is a decision that needs to be made between you and the patient.

In this section, Digene provides reimbursement information supporting HPV testing, including which insurance companies currently offer coverage for primary screening and which labs offer HPV screening. Your local Digene representative can provide you with more detailed information regarding the payers in your area.

For general questions or to request local reimbursement information, please e-mail Digene at inforeq@digene.com. Please be sure to provide your name, phone number, city and state.

For coverage and coding questions, verification of individual benefits, or claim support, please call The Digene Reimbursement Hotline* at 1-866-895-1HPV or click here.

* "The Digene HPV Test" was approved by the US FDA and is also known to laboratories and physicians as the "hc2 High–Risk HPV DNA Test^®" and "DNAwithPap^® Test." This does not refer to the Digene product that tests for several types of the virus commonly referred to as "low–risk HPV," which are not associated with cervical cancer.