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...]

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...]

REIMBURSEMENT

Despite Changes in Final PAMA Rule, Many Hospital Labs May Still Not Be Reporting

When the Centers for Medicare & Medicaid Services announced in mid- June the final rules governing the Protecting the Access to Medicare Act (PAMA), it drew praise from several groups that had … [Read more...]

Two Prominent Senators Push CMS to Make Changes on PAMA Rules

The Congressional pressure on the Centers for Medicare & Medicaid Services to make changes to its proposed final rules on the Protecting Access to Medicare Act (PAMA) have been ramped up, with two … [Read more...]


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