Dunedin, New Zealand – Cancer diagnostics company Pacific Edge (NZX/ASX: PEB) has confirmed that its Cxbladder Triage and Triage Plus tests will receive Medicare coverage. The final Local Coverage Determination (LCD) for urine-based biomarkers in patients with microhematuria has been published, establishing hematuria evaluation as a covered Medicare benefit. Pacific Edge is a global cancer diagnostics company that develops and commercialises bladder cancer diagnostic and prognostic tests for patients. The policy, effective 20 December 2026, provides foundational medical guidelines for validated urine-based biomarkers in evaluating intermediate-risk microhematuria patients.
This confirmation significantly bolsters Pacific Edge’s market position, as Cxbladder Triage and Triage Plus are the only tests covered under the new LCD, with competing tests and generic billing codes non-covered. The coverage is expected to remove key logistical and reimbursement barriers for urologists. Financially, Medicare reimbursement is projected to meaningfully increase the average selling price (ASP) for these tests, fostering revenue growth and operating leverage. Notably, Triage and Monitor were recently re-priced at US$1057/test and US$1026/test respectively, with Triage Plus at US$1,328/test, further enhancing this financial outlook.
Pacific Edge anticipates Medicare Advantage payers will align with this policy, boosting cashflow, and expects to leverage the Medicare decision to influence commercial payers, thereby improving policy adoption and associated revenues. Existing commercial contracts, such as with Geisinger, already cover 12.9 million lives for hematuria tests. Chief Executive Dr Peter Meintjes described the LCD as a “significant milestone,” offering clear guidance for eligible hematuria patients and underscoring the vital role of non-invasive urine-based biomarkers. He added that the policy solidifies Pacific Edge’s market leadership due to its commitment to generating robust evidence. The company plans selective investments in its commercial team and digital technologies to capitalise on this opportunity.
