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...]
FEE SCHEDULES
CORRECTION: Molecular Assays Stave Off Big Cuts in 2017 Clinical Laboratory Fee Schedule
May 17, 2017
FEE SCHEDULES
Crosswalked Codes in 2017 Clinical Laboratory Fee Schedule
November 30, 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
OIG Surveys How CMS is Doing on PAMA Implementation
October 28, 2016
With D-day set for Jan. 1, 2018 for implementation of a new payment methodology for lab services under the Protecting Access to Medicare Act of 2014 (PAMA), the Office of Inspector General (OIG) just … [Read more...]
CMS
PAMA Update: CMS Guidance and Reporting Information Trickles In
September 29, 2016
The Centers for Medicare & Medicaid Services (CMS) promised more details would be coming once it released the final rule implementing the Protecting Access to Medicare Act of 2014 (PAMA) this past … [Read more...]
FEE SCHEDULES
Are Commercial Payers Using Proposed CMS Gapfill Rates to Ratchet Down Reimbursement?
September 15, 2016
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...]
FEE SCHEDULES
CMS Proposes Pathology, Cytology Cuts for 2017 Physician Fee Schedule
August 11, 2016
CPT Code 88305 is headed to the chopping block again. The Centers for Medicare & Medicaid Services (CMS) has suggested cutting the technical component of 88305—a tissue examination and a primary … [Read more...]
PAMA
The PAMA Snag: Many Hospital Labs May Not Be Able to Participate in Reporting
August 11, 2016
When the Centers for Medicare & Medicaid Services (CMS) announced in mid-June the final rules governing the Protecting the Access to Medicare Act (PAMA), it drew praise from several groups that … [Read more...]
REIMBURSEMENT
Reimbursement for Molecular Testing Faces Cuts in CMS’ Proposed Gapfill Prices
July 14, 2016
The Centers for Medicare & Medicaid Services (CMS) published interim gapfill prices last month for new CPT codes for molecular tests introduced earlier this year. Although the pricing was for a … [Read more...]
Proposed Medicare Fee Schedule Changes Acknowledge Compliance Realities and Focus on Value
July 23, 2015
In the wake of the SGR's demise and the rise of alternative payment models, the Centers for Medicare and Medicaid Services' latest proposed revisions to the Medicare fee schedules support those … [Read more...]
CMS Proposes More Cuts to Lab Payments; Pathology Services Could See 26% Hit
If the ongoing Medicare payment cuts for clinical laboratory services weren’t enough, the Centers for Medicare and Medicaid Services (CMS) is now proposing to reduce payment under the clinical … [Read more...]
