XiFin’s Payor Rate Transparency Monitor Helps Clinical Labs Compare In-Network Rates
The free online tool can set a foundation for renewed reimbursement strategies and contract negotiations with insurance carriers
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Articles and Reports
Reimbursing Genetic Counselors in the Clinical Lab
Sara Pirzadeh-Miller offers advice on overcoming the reimbursement barriers genetic counselors face in the clinical lab and beyond
Change and Constancy: The 2025 CLFS Update
The 2025 CLFS update—what has changed, what has stayed the same, and what that means for diagnostic test reimbursement in 2025
How to Avoid a Laboratory Audit
By Sean McSweeney bio
Laboratory audits have a much harder impact on your lab than intended. As detailed by the NCBI, the audit's intent is to review and…
PAMA Unlocks Golden Age for Innovative Diagnostics
By Chance Scott bio
The publication of the 2018 Clinical Laboratory Fee Schedule (CLFS) in January saw a long and heated debate within the lab community come to fruition…
How PAMA’s Effect in 2018 Molecular Diagnostic Reimbursement Will Make Labs More Money
By Sean McSweeney bio
The year 2018 is slated to be much brighter for molecular diagnostic labs as PAMA fee schedules show a higher payment rate and amount for many cancer genomics and…
Emerging Tests: Medicare to Cover Next Gen-Sequencing Tests for Advanced Cancer
From - Laboratory Industry Report
In the PAMA era, there are two salient trends in Medicare Part B lab reimbursements…
Out of Network: 6 Frequently Asked Questions
By Richa Singh bio
As labs face an increasingly challenging reimbursement environment, more providers are doubling down on out-of-network strategies to maximize on collections opportunities…
PAMA-geddon: Lab Industry Asks Court to Stop New Medicare Fee Schedule
From - Laboratory Industry Report
With CMS refusing to back down, the lab industry has escalated the dispute and asked a U.S. District Court to step in and prevent enforcement of the 2018 PAMA-inspired…
CMS Ignores Flawed Processes, Finalizes 2018 PAMA Pricing; Labs Need to Take Immediate Action to Offset Impending Lean Times
By Kyle Fetter bio
The final 2018 clinical laboratory fee schedule (CLFS) is out, and it is evident that the argument that the Centers for Medicare & Medicaid Services (CMS) PAMA process was…
PAMA-Geddon: CMS Slashes 2018 Part B Lab Rates
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“Applicable Labs”: The Fly in the PAMA Market-Based Pricing Ointment
From - Laboratory Industry Report
The lab industry has no objection to basing Medicare payments for lab tests on the actual rates charged to payors in the private market. What has the industry so upset is how…
FDA Watch: Diagnostics Industry Is Losing a Longstanding “Frenemy”
From - Laboratory Industry Report
The diagnostics community is saying goodbye to a frenemy of 25 years. On Aug. 29, Alberto Gutierrez, director of the…