REIMBURSEMENT

Update on Palmetto’s Molecular Dx Testing LCDs

Advanced diagnostic tests are emerging faster than the clinicians can document their clinical utility. All of this creates an interesting dilemma for payors as far as coverage is concerned. Normally … [Read more...]

LCDs

Palmetto Latest Medicare Contractor to Loosen Up on Covering Molecular Dx Testing

Advanced diagnostic tests are emerging faster than the clinicians can document their clinical utility. All of this creates an interesting dilemma for payors as far as coverage is concerned. Normally … [Read more...]

FEE SCHEDULES

3 Things You Need to Know about the Lab Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) issued the final 2017 Clinical Laboratory Fee Schedule (CLFS) on Nov. 21. Here is a look at the three key changes you need to know about going into … [Read more...]

REIMBURSEMENT

OPPS 2017: The 4 Things Labs Need to Know

The Centers for Medicare and Medicaid Services (CMS) recently published final rules on reimbursement under the Medicare Hospital Outpatient Prospective Payment System (OPPS) for 2017. In case you do … [Read more...]

FEE SCHEDULES

2017 Clinical Laboratory Fee Schedule: The 3 Changes Affecting Your Reimbursement

The Centers for Medicare and Medicaid Services (CMS) issued the final 2017 Clinical Laboratory Fee Schedule (CLFS) on Nov. 21. The winners: The small group of labs that provide new specialty molecular … [Read more...]

FEE SCHEDULES

Crosswalked Codes in 2017 Clinical Laboratory Fee Schedule

CPT Code Crosswalked To 80305 (Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical … [Read more...]

PAMA

PAMA Update: Status Report on Implementation of New Medicare Fee Schedule for Part B Lab Tests

Changes to Medicare Part B payment for lab tests under the Protecting Access to Medicare Act of 2014 (PAMA) take effect on Jan. 1, 2018. Less than 15 months from the deadline, the Office of Inspector … [Read more...]

REIMBURSEMENT

OIG Report: Total Medicare Lab Test Payments in 2015 Same as in 2014

Medicare Part B paid $7 billion for lab tests in 2015, the same amount it shelled out in 2014. But 2015 Medicare payments for the top 25 lab tests dipped slightly to $4.1 billion, as compared to $4.2 … [Read more...]

REIMBURSEMENT

OIG Addresses Status of PAMA Implementation

Changes to Medicare Part B payment for lab tests mandated by the Protecting Access to Medicare Act of 2014 (PAMA) take effect on Jan. 1, 2018.  Less than 15 months from the deadline, the Office of … [Read more...]

FEE SCHEDULES

Are Commercial Payers Citing Proposed CMS Gapfill Rates, Trying to Negotiate Lower Reimbursement?

During the summer, the Centers for Medicare & Medicaid Services (CMS) published proposed interim gapfill prices for 15 molecular tests. The agency said it would likely publish final prices later … [Read more...]


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