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...]
PAMA
Draft 2018 CLFS Reveals Fundamental Flaws in PAMA Reporting Exercise; Time to Take Action
October 2, 2017
PRECISION MEDICINE
Medicare Reimbursement: 4 Molecular Assays Score Big Coverage Wins
September 29, 2017
Molecular labs continue to gain ground with Medicare securing four key approvals via finalization of Local Coverage Determinations (LCDs) issued by principal contractor Palmetto GBA this spring. All … [Read more...]
MOLECULAR TESTS
Palmetto Gives Okay to Medicare Coverage of 5 New Molecular Tests
July 17, 2017
Medicare contractors are slowly coming around on covering unproven molecular assays. The most notable new baby steps come from, Palmetto GBA (Columbia, SC), one of Medicare's most important … [Read more...]
REIMBURSEMENT
Update on Palmetto’s Molecular Dx Testing LCDs
January 6, 2017
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
December 29, 2016
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
December 6, 2016
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
November 29, 2016
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
November 25, 2016
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
November 7, 2016
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
October 20, 2016
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...]
