Medicare Lab Test Pricing Forum Set for July 10

The Centers for Medicare and Medicaid Services (CMS) will hold a public meeting July 10 at its Baltimore headquarters to hear recommendations on setting Medicare payment rates for new or substantially revised clinical laboratory codes for the Part B lab fee schedule in 2014. All presenters for the public meeting must register and submit their presentations electronically to Glenn McGuirk by June 28: Glenn.McGuirk@cms.hhs.gov. The agency announced the meeting in the May 24 Federal Register. Comments on the new or revised codes are due by June 28. CMS will determine pricing of the codes either through crosswalking (mapping to an existing code) or gap-filling (pricing determined by Medicare contractors based on charges, resources, and payment amount determined by other payers). The agency plans to publish proposed determinations for new and reconsidered codes for 2014 by early September. Final fee decisions are expected in November. For the 2014 clinical laboratory fee schedule, there are 16 new Current Procedural Terminology codes and 11 reconsideration requests. (Note: numbering of new codes will be finalized later.) NEW AND RECONSIDERED CODES FOR THE 2014 MEDICARE LAB FEE SCHEDULE* NEW TEST CODES THERAPEUTIC DRUG ASSAYS 801XX1 Caffeine 801XX2 Clozapine 801XX3 Everolimus 801XX4 Gabapentin 801XX5 Lamotrigine 801XX6 […]