Autoimmune Brain Panel™

Cost & Insurance

Testing Costs and Coverage

The Autoimmune Brain Panel™ requires a clinician order before we can receive and process any specimen. Moleculera Biosciences can accept clinician test orders from all 50 states in the U.S. and other countries. Practitioners in New York State may order the Autoimmune Brain Panel™ but specimens must be collected at a facility outside the State of New York. Patients residing outside the U.S., please see our International Ordering Page.

Insurance is filed once the test report has been released. The date of service used to file the insurance is the date the specimen was collected.

Employer Group Insurance
$495 initial deposit payment is required prior to testing. Total patient cost is $995. Moleculera does not accept insurance but can file a claim on your behalf, as a courtesy.
Individual/Family Insurance
$495 initial deposit payment is required prior to testing. Total patient cost is $995. Moleculera does not accept insurance but can file a claim on your behalf, as a courtesy.
Government-sponsored Programs
(Medicaid, Medicare, Tricare, CHAMP-VA) Full payment of $995 is required prior to testing. Moleculera is unable to file a claim on your behalf.
Self-pay insurance for Autoimmune Brain Panel
Self-pay
Full payment of $995 is required prior to testing.

Approximately 50% of patients receive some level of reimbursement.

Documents that may be helpful in acquiring coverage:

INSURANCE
DOCUMENTS

Insurance Checklist for Autoimmune Brain Panel
Insurance Coverage Checklist
Review our checklist to start a discussion with your insurance carrier about potential coverage for testing.
Sole Provider Letter
Moleculera Biosciences is the only lab that performs this panel. Ask your insurance company to consider Moleculera Biosciences as in-network.
Medical Necessity Letter
Ask your healthcare provider to write a “Letter of Medical Necessity” to your insurance company. You or your provider should submit this letter to your insurance company prior to having blood collected.

We are committed to making testing available to all patients in need.

Moleculera Biosciences is a small company with limited resources. At this time, we do not have a foundation or grant assistance available. However, we will work with patients/caregivers on a case-by-case basis to make payment arrangements for balances. Please contact our billing department at billing@moleculera.com for more information.

Payment Process is Easy!

Order Autoimmune Brain Panel
ORDER
After your provider places an order, you should receive an email link to our payment portal.
REGISTER
Register in our secure online payment portal. You will need to enter your patient ID #.
DEPOSIT PAYMENT
Submit your deposit or full payment, along with insurance information through the portal.
CONFIRMATION
You will receive a confirmation email after your payment has been processed.
Deposit Payment for Autoimmune Brain Panel
PAY MY BILL
If testing has been completed and you have received a bill, you can make an online payment by using our Online Bill Pay system.
Click below to make a deposit or to pay your invoice balance online.
Order Codes

Procedure codes (CPT Codes)

There are 3 procedure codes for the Autoimmune Brain Panel™.

  • 83520 × 4 – Immunoassay for Analyte
  • 88230 – Tissue culture for non-neoplastic disorders; lymphocyte
  • 86352 – Cellular function assay involving stimulation and detection of biomarker

ICD-10 Diagnosis codes

ICD-10 diagnosis codes are used when filing an insurance claim to help the insurance carrier determine the medical necessity of the test.

The healthcare provider will submit ICD-10 codes when ordering the Autoimmune Brain Panel™. There are no specific codes that will increase the likelihood of insurance coverage for your test. Presently there is no ICD-10 code for PANS/PANDAS.

Cancellation Policy

Once a specimen has been received, testing cannot be cancelled and no refund will be issued.

Specimen not yet received

  • If a patient has received collection supplies from Moleculera but not yet submitted a specimen, testing can be cancelled.
  • We will refund the advanced payment, minus $50 (shipping/handling fee). (NOTE: If the patient received collection supplies from the provider, a full refund will be given.)
  • If cancelled within 120 days of initial payment, we will refund to the original credit card. Cancel after 120 days, we will refund by check.
Reshipment Policy

For specimen collection supplies: If a specimen must be rejected it may be necessary to ship new specimen collection supplies to a patient. There may be a charge. Please see the table below.

Moleculera Shipped Supplies

  • If a specimen was rejected because supplies were not delivered in an appropriate timeframe, there will be no reshipment fee.
  • If a specimen was rejected due to a failure to follow collection and/or shipping instructions, there will be a $50 reshipment fee.

Moleculera Shipped Supplies (international)

  • Fees will be based on current shipping rates to your location and reason for reshipment.

Clinician Provided Supplies

  • No reshipment fee.