BioCentury
ARTICLE | Politics & Policy

CMS proposes update to lab diagnostic reimbursements

September 29, 2015 12:52 AM UTC

CMS proposed an update to its Clinical Laboratory Fee Schedule (CLFS), under which laboratory-reported payments from private insurers would be used to calculate Medicare payments for clinical diagnostic tests. The new payment rates would be effective Jan. 1, 2017.

Under the proposed rule, laboratories would be required to report private payer rate and volume data if the majority of their Medicare payments are paid under the CLFS or Physician Fee Schedule (PFS) and they receive at least $50,000 on the CFLS. The weighted median of payments from private payers would be used to calculate Medicare payments. ...