FEE SCHEDULES

OPPS 2018: Revised Payment Rates & a New ADLT Date of Service Exemption

With all of the PAMA commotion, CMS's publication of the 2018 Medicare Hospital and Ambulatory Surgical Outpatient Prospective Payment System (OPPS) final rule has flown under the radar. In case you … [Read more...]

TOP OF THE NEWS

PAMA-Geddon: CMS Slashes 2018 Part B Lab Rates

Resisting industry pleas for a delay, CMS is sticking to the Jan. 1 start date for the new PAMA payment system. Even worse, it's sticking to its misguided formula for pricing lab tests. Result: The … [Read more...]

MEDICARE COVERAGE

“Applicable Labs”: The Fly in the PAMA Market-Based Pricing Ointment

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 CMS has executed the … [Read more...]

PAMA

Draft 2018 CLFS Reveals Fundamental Flaws in PAMA Reporting Exercise; Time to Take Action

By Lâle White  bio As XIFIN predicted, the PAMA reporting exercise has resulted in significant proposed laboratory fee cuts. In fact, the multi-year decrease for the top 20 laboratory tests … [Read more...]

FEE SCHEDULES

CORRECTION: Molecular Assays Stave Off Big Cuts in 2017 Clinical Laboratory Fee Schedule

  Editor's Note: The lead story in the November 25, 2016 issue of LIR is about changes to the 2017 Clinical Laboratory Fee Schedule affecting reimbursement for clinical laboratory tests. The … [Read more...]

REIMBURSEMENT

CMS Enforcement Discretion Eases Pressure on Labs

After we went to press last month, the Centers for Medicare and Medicaid Services (CMS) announced just in the nick of time that it wouldn't impose civil monetary penalties against labs which failed to … [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...]

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...]


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