Focus On: Clinical Laboratory Fee Schedule: CMS Gets Pricing Advice for New 2015 CPT Lab Codes

Leading scientific advisory societies and national clinical laboratory groups gathered in Baltimore July 14 to make recommendations on Medicare pricing for new and revised lab testing codes that will be added to the Part B lab fee schedule as of Jan. 1, 2015. Recommendations from four leading organizations — the American Clinical Laboratory Association (ACLA), American Society for Clinical Pathology (ASCP), American Association for Clinical Chemistry (AACC), and American Society for Clinical Laboratory Science (ASCLS) — are listed below. MEDICARE LAB FEE SCHEDULE FOR 2015: NEW CPT CODES AND PAYMENT RECOMMENDATIONS CODE DESCRIPTOR CODE CROSSWALK OR GAP-FILL PROPOSED NLA PRESUMPTIVE DRUG SCREENS 801XXX1 Drug Screen ACLA, ASCP, AACC, ASCLS: Crosswalk to G0434 $19.84 801XX2A Drug Screen ACLA: Crosswalk to G0431 minus 39% ASCP: Crosswalk to G0431 minus 43% AACC, ASCLS: Crosswalk to G0431 $60.51 $56.55 $99.20 801XX4A Drug Screen ACLA, ASCP, AACC, ASCLS: Crosswalk to 82491 $24.63 801XXX6 Drug Screen ACLA, ASCP: Crosswalk to 82489 $25.23 801XXX7 Drug Screen ACLA: Crosswalk to 82541 ASCP, AACC, ASCLS: Crosswalk to 82492 $24.63 $24.63 DEFINITIVE DRUG ASSAYS 801XY1 Alcohols ACLA, ASCP, AACC, ASCLS: Crosswalk to 82055 $14.74 801XY2 Alcohol biomarkers; 1 to 2 ACLA, ASCP: Crosswalk to 82055 AACC, ASCLS: Crosswalk to 82542 […]