BioCentury
ARTICLE | Politics & Policy

CMS delays start of lab fee change

June 21, 2016 12:38 AM UTC

CMS issued a final rule updating its Clinical Laboratory Fee Schedule, delaying the effective date for new Medicare reimbursement rates for diagnostic tests to Jan. 1, 2018, from Jan. 1, 2017. As proposed last September, the new Medicare payment rates for lab tests will be based on laboratory-reported payments from private insurers (see BioCentury Extra, Sept. 28, 2015).

Qualifying laboratories will first collect private payor data from January to June 2016, and report it to CMS between January and March 2017. CMS said laboratories with at least $12,500 in CLFS revenue from Medicare and more than half of its Medicare revenue from laboratory or physician services will be required to report private insurance payments and test volumes. ...