Payment System Final Rule for Lab Tests Published

Medicare Clinical Diagnostic Laboratory Tests Payment System Final Rule

3461-3461-cms-logo-250x100_6zMZ22.png.jpgSection 216(a) of the Protecting Access to Medicare Act of 2014 (PAMA) added section 1834A to the Social Security Act (the Act), which requires revisions to the payment methodology for clinical diagnostic laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS). Under the final rule, reporting entities will be required to report private payor payment rates for laboratory tests and the corresponding volumes of tests. Private payor rates for laboratory tests from applicable laboratories will be the basis for the revised Medicare payment rates for most laboratory tests on the CLFS beginning in January 2018.

Via: Medicare Clinical Diagnostic Laboratory Tests Payment System Final Rule

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