CMS announced a 47 % increase in Medicare reimbursement for the Category I CPT code 81195, which covers optical genome mapping (OGM) tests for hematologic malignancies. The payment rate rises from $1,263.53 to $1,853.22 and will take effect on January 1 2026, giving Bionano Laboratories a higher fee per test and a stronger revenue base for its diagnostic services.
The higher fee is a welcome boost for Bionano Genomics, whose diagnostic arm has struggled with thin margins and a high burn rate. In the third quarter of 2025, Bionano reported $7.4 million in revenue from OGM diagnostics, a 21 % year‑over‑year increase, and a non‑GAAP gross margin of 46 %, up from 38 % in the prior quarter. Operating expenses fell 40 % year‑over‑year, reflecting the company’s aggressive cost‑control program. The company’s full‑year 2025 revenue guidance of $26‑$30 million remains unchanged, but the new reimbursement rate is expected to improve cash flow and help offset the cash burn that has kept the company in a liquidity‑challenged position.
Bionano’s liquidity challenges have been a recurring theme in recent earnings calls. The company has a modest cash balance and a burn rate that requires additional financing to sustain operations. The CMS decision is therefore a critical tailwind, as the increased fee per test will raise revenue per test and improve the profitability of the diagnostic platform, potentially reducing the need for external capital in the near term. The company’s management has emphasized that the higher reimbursement will support its strategy to expand OGM utilization among routine users and to accelerate adoption of the second Category I CPT code 81354, which covers constitutional genetic disorders.
The CMS payment increase also signals broader acceptance of OGM technology. OGM offers a faster, more comprehensive alternative to traditional karyotyping, FISH, and microarray methods, and the higher Medicare fee reflects the technology’s clinical value in detecting structural variants in blood cancers. By validating OGM’s utility, the decision is likely to encourage more laboratories to adopt the platform, which could drive volume growth for Bionano’s consumables and instrumentation sales.
The payment change is part of the final CMS Physician Fee Schedule for calendar year 2026, issued on October 31 2025. The schedule included adjustments to conversion factors and payment methodologies across many diagnostic codes, and the OGM increase is one of the most significant changes for genomic testing. Bionano’s leadership views the reimbursement boost as a key enabler for scaling its diagnostic services and strengthening its competitive position in the rapidly evolving genomic diagnostics market.
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