Susan Bobulsky: Yes, absolutely, Mark. So you’re correct that it will go live formally on January 1st after it’s finalized later this year. We are already leveraging the published preliminary rate in conversation with commercial payers. So there are two implications. In the short term, we have several large non-contracted payers who have been holding out waiting for the PLA price to be published so that they could complete their negotiations on price with us. And so we’ve already engaged them to advance the negotiations. And of those of note, Ansem [ph] is a particularly large one that we’re working with utilizing the recently published price. Additionally, over time, we can use this price to re-approach existing contracted payers to potentially bring up contracted rates that we’ve previously negotiated if they are below the PLA price.
Chad Robins: And one other comment, Mark, worth noting, as we mentioned a couple of times, the preliminary pricing rate. Obviously, there’s no promise that we continue to work with Moldex on finalizing the price and the episode structure.
Mark Massaro: That’s great. And then one last one for me. You took up the low end of the guide for MRD. I assume that’s just cycling in the $4.5 million milestone that you realized in Q1. Just clarifying that, and then how should we think about the total contribution in MRD milestones for the full year?
Kyle Piskel: Yes, Mark, that’s Kyle. Yes, the beat and the low end poll fully related to the milestones. As it relates to the go-forward, I’d say we continue to be conservative as we think about the milestones in our guide. We’re not necessarily anticipating anything. We don’t control the timing, and we’ll see how it plays out throughout the rest of the year still early.
Mark Massaro: Okay, thanks, guys.
Operator: Thank you very much. One moment while we gather our next question. Our next question comes from the line of David Westenberg of Piper Sandberg. David, your line is open.
David Westenberg: Hi. Thank you for taking the question and congrats on all the progress here. I mean, that’s a really nice update, the 1823. It is higher than I remember. I think it was up $6,874 [ph]. So it was like $1,700 a test, which is about a little over $100. Now, you said you think that you can have this be $200. So can you run us through the math that gets to $200 versus the other difference there? Also, I just want to have a clarification because the last payment was for four tests at that $6,870 rate. With this new rate, does that imply that it’s kind of no open end? I mean, no closed end after that fourth test. And I just want more question. Thank you.
Chad Robins: Yes, maybe I’ll start, Susan, if you want to add color, you can add the word. Remember, the $200 in ASP raised over the next two years is a combination of multiple factors. We talked about reducing auto policy claims and non-contracted claims. And we’re doing a lot of work operationally on revenue cycle management, faster collections. We’re actually implementing AI and the appeals process. There’s a whole bunch of things that we’re doing just to collect money faster. So as Susan just mentioned, having the new gap bill per price test will also allow us to use that dollar amount to go and close some of those non-contracted claims gap that will further enhance it. But if you look at the Medicare percentage of tests, this is, I would say, I’m going to call it right now a risky event to allow us to get to the $200.
But it wasn’t necessarily contemplated originally in that $200. So I want to be careful, but could represent some potential upside. But certainly, at least all we’re looking at right now is at least de-risking, and we’re quite confident that we’re going to be able to get that $200 increase over the next two-year period. The second, I wasn’t sure I totally understood your second question, David, if you could maybe ask it again.
David Westenberg: If I’m not mistaken, your original rate was $6870 for four tests. And I wasn’t sure after the fourth, like the fifth test, did you get $17.50? I don’t remember if you actually did. I kind of remembered you didn’t, but I could be wrong. I mean, my memory was failing from time to time. So I was thinking if there’s any update in terms of being able to get paid in perpetuity versus if there’s like a fixed number, rate number of tests.
Chad Robins: Yes, so okay, a couple of comments here, David. On the Medicare episode structure, we don’t get paid yet for what we’ll call recurrence monitoring. That being said, we have a submission in right now in our first indication for mantle cell lymphoma that we have nice data on our first kind of recurrence monitoring test that could essentially, once a patient goes into remission, kind of sets a new bar on a per test rate for Medicare. Separately, on commercial payers, we don’t have a limitation on a per case basis so we can get paid in perpetuity for as many tests as deemed medically necessary.
David Westenberg: Got it. Okay. Thank you very much. And just as my follow up, is there, I just want to be the ODAC meeting another really positive development here. Is there differences in behavior in the way MRD is used in clinical trials in pharma versus how it’s used in clinical? And specifically, I’m kind of thinking about things like testing interval or testing in terms of timing and when the test is done. And the reason why I’m asking you this question is, does this have a chance to change behavior in the clinic in terms of maybe test frequency and use cases following greater usage in clinical trial and after I’m done after that?
Susan Bobulsky: Sure. No, thanks, David, for the question. I mean, certainly we see that there are synergies in both directions between the MRD, pharma, and clinical use cases. And depending on the setting in which the trial is being performed, depending on the type of patients who are eligible for the study, the time points and frequency of testing can vary and may also vary in the clinic for those exact same reasons. So while there are no definitive differences that I would call out between clinical and pharma-based use of the test, certainly the use is customized to the particular need of the investigator or the clinician and patient. One thing, though, that I would call out is that in the clinic, blood-based testing has begun to really take shape with about 20% of our MRD tests now coming from blood and myeloma.
That’s something that pharmas have great interest in, but we have not yet really explored in depth. And I certainly think that with the incorporation of MRD and endpoint myeloma, there will be quite a few additional opportunities that will open up exploration of deeper sensitivity testing in pharma studies as well as potential use of blood down the red.
