CMS Adjusts Specimen Collection Fee in Limited Circumstances

Laboratories that collect blood samples from people in nursing homes or on behalf of a home health agency are having their collection fee increased from $3 to $5, effective April 1, 2014. The change, announced by the Centers for Medicare and Medicaid Services in Transmittal 3056 (Change Request 8837), was mandated by the Protecting Access to Medicare Act. For this situation, a new code will be used: G0471, Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (SNF) or by a laboratory on behalf of a home health agency (HHA). The fee is raised from $3 to $5 only when the following statements apply: The sample is being collected by a laboratory technician who is employed by the laboratory that is performing the test; and The sample is from an individual in either an SNF or an HHA. The change in payment is retroactive to April 1, 2014, but Medicare administrative contractors (MAC) will not search their files to adjust claims already processed. Therefore, labs should bring such claims to the attention of their MAC. Takeaway: Labs that serve nursing homes and home health agencies will get a bump in […]