Centers for Medicare & Medicaid Services (CMS) have confirmed the payment rate for the PromarkerD predictive test for diabetic kidney disease of US$390.75 in the United States. CMS is the single largest payer for health care in the United States, with Medicare and Medicaid collectively responsible for 42 per cent of healthcare spending and providing health coverage to more than 100 million Americans. Approximately 32 million adults live with diabetes in the United States whilst globally this number totals 537 million adults.