Payment/Insurance Information

How much do your tests cost?

Metametrix offers a choice of pricing plans, determined by the payment method chosen on the Test Requisition Form at the time the specimen is sent to the laboratory.

List Price: The actual price of the test or profile. Metametrix uses this list price when filing medical claims for patients with private insurance only. The patient is responsible for the entire balance not covered under the patient's insurance plan.

Patient Prepaid Price: A discounted price offered to patients for prepayment. Payment in full must be submitted with the specimen to qualify for this price. An itemized receipt for insurance filing by the patient will be mailed to the patient. Metametrix does not bill patients under this plan. This plan applies to all patients in New York, since Metametrix does not file any insurance claims in New York State.

Clinician Billing*: Clinician billing is up to your clinician. In this option, you pay your clinician directly for the testing services. Your clinician will then be billed by Metametrix and be responsible for payment. Please contact your physician directly to discuss this option.

*Exception - New York State: Clinicians in New York State are unable to bill patients for laboratory services. All New York patients must use the pre-pay option.

What are the acceptable payment methods?

Patient or health professional's credit card (Visa/MC/AMEX/Discover), money order, or check payable to Metametrix, Inc. Please indicate method of payment on the Test Requisition Form under "Check or Credit Card Information".

Metametrix will not accept checks or money orders drawn on non-US banks.

Is Metametrix testing covered by insurance?

As a courtesy, Metametrix will file medical claims for patients with private insurance only. We are not a participating provider with any insurance company and therefore all testing is considered out-of-network by all insurance companies. The patient is responsible for paying any portion of the test not covered by insurance. To qualify for insurance billing, payment in full must accompany the specimen. All Medicare patients must prepay for their testing before Medicare can be filed. They are also required to sign the Test Requisition Form indicating they are a Medicare patient.

Note: We do not file insurance claims for Worker’s Compensation and Medicaid. For Medicare coverage please see Medicare question below.

Exception - New York State: Metametrix does not bill patients or file any medical claims with private insurance, Medicaid, or Worker's Compensation. We do not file insurance claims (except for Medicare) for New York patients since NY State is required to reimburse the patient directly.

How do I find out if my insurance company will cover testing?

Patients should contact their insurance company for coverage information. Your insurance company will need the procedure (CPT) codes to verify coverage. For a list of CPT codes click here.

Why is New York billing different than other states?

In compliance with NY State law, Metametrix cannot bill or receive payment from NY State health professionals for laboratory testing. Patients are solely responsible for payment for laboratory services. Patients will pay the Patient Prepaid price. Metametrix does not bill patients.

Do you file with Medicare?

We file all claims to Medicare for patients under the Medicare plan. Medicare has deemed the following profiles to be diagnostic in nature; therefore prepayment is not required when submitting: 0020, 0022, 0026, 0052, 0058, 0152, 0158, 2100, 2105, 2110, 2115, and 2120. Any amounts deemed patient responsibility by Medicare will be the sole responsibility of the patient and due immediately. For all other tests not listed above, the patient will need to submit 20% of the list price amount with specimen submission. Please ensure that the patient includes all Medicare information and signs the Test Requisition Form where indicated and completes the Advanced Beneficiary Notice (ABN). Medicare will most likely deny benefits for all other tests not listed above. The patient will receive an explanation of benefits from Medicare that they may forward to their secondary insurance company, if applicable.