Opt-e-scrip Personalized Medicine Tests are dispensed in response to a physician's prescription.
You may use our standard prescription form where allowed by state law. If you
use your own prescription pad, it should contain the following information:
- number of doses, drug name, strength, dosage form and dosing frequency of 1st test drug (e.g., one Zyrtec 10 mg tablet qd)
- number of doses, drug name, strength, dosage form and dosing frequency of 2nd test drug (e.g., one chlorpheniramine maleate 12 mg sustained release capsule bid)
- Indicate Opt-e-scrip Kit/Protocol number
- State "placebo, blind and label per protocol "
After submitting a prescription, please instruct your patient to call the Opt-e-scrip Patient
Enrollment Center at 1-866-678-3727
Opt-e-scrip test kits have been assigned the Class III CPT Code "0130T".
Please click below to access our prescribing protocols:
Personalized Medicine Test Exception Policy
Opt-e-scrip recognizes that instances might arise in which best practice dictates that a specific agent or class of agents might not be appropriate for a given patient, or, a specific test agent or class of agents might be uniquely appropriate for a given patient, or that the patient or the caregiver, if any, is unable to comply with the test. Therefore, the physician has the ability to specify that specific agents or classes of agents be excluded from the PMT or that the PMT be eliminated entirely. This requires that the prescribing physician complete the PMT Exception Form citing the reasons for this conclusion and providing appropriate findings which support it. Three independent physicians will review this form and in the event that a majority supports the opinion of the prescribing physician, such an action will be allowed. This review process will take no longer than three working days.
Follow this link for a list of
Health Plans
that currently cover Opt-e-scrip Personalized Medicine Tests.
If your patient is not covered by a participating prescription plan, follow this link for information on
Prices and Savings
available to cash customers.
Please contact us if you would like more information about prescribing
Opt-e-scrip kits. Our toll-free number is 1-866-678-3727.
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