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Compliance Alert: Revised Medicare Part B Travel Allowance Rules

by | Dec 14, 2022 | News, Open Content

What labs need to know to maximize travel allowance reimbursements.

Revised Medicare Part B travel allowance rules go into effect on January 1, 2023. Here’s a quick briefing on the Centers for Medicare & Medicaid Services (CMS) final rule.

The New Laboratory Travel Allowance Regulation

Eligibility: Under the final rule, Medicare will only pay a travel allowance if the lab technician collects a specimen that qualifies for payment of a specimen collection fee. In other words, the specimen collection must:

  • Require a trained technician;
  • Be for a Medicare beneficiary who is either homebound or an inpatient at a facility other than a hospital; and
  • Be for a lab test that’s covered by Medicare.

Billing Restrictions: The final rule bans submitting claims for a travel allowance where the technician acts merely as a messenger to pick up the specimen. In addition, the allowance applies only to “eligible miles” traveled. To calculate “eligible miles,” you begin at the lab or starting point of the technician’s travel for qualifying specimen collection and end at the lab or ending point of the technician’s travel. You may not count miles traveled for any purposes that aren’t related to qualifying specimen collection, e.g., personal errands or collections from patients who aren’t Medicare beneficiaries.

Rates: The payable travel allowance amount will vary depending on distance traveled and numbers of locations:

Flat Rate: Medicare will pay a flat travel rate allowance if the trained technician travels 20 eligible miles or less to and from one location to collect specimens from one or more Medicare beneficiaries. 2023 Flat Rate: $10.40 divided by the number of Medicare beneficiaries who received a qualifying specimen collection.

Per-Mile Rate: Medicare will pay a per-mile travel allowance when a trained technician travels either: (i) more than 20 eligible miles to and from one location for specimen collection from one or more Medicare beneficiaries; or (ii) to more than one location for specimen collection from more than one Medicare beneficiary. 2023 Per Mile Rate: $1.04 per mile multiplied by eligible miles traveled divided by the number of Medicare beneficiaries who received a qualifying specimen collection.