New Medicare Lab Payment Rates

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“The CMS has finalized a rule under which it will begin paying the same as private insurance rates for clinical diagnostic laboratory tests…

“Medicare’s current fee schedule for lab tests has been in place since 1984 and has been largely unchanged, according to the agency…

Laboratories must collect private payer data from Jan 1, 2016 through June 30, 2016, with reports due to the CMS by March 31, 2017. The CMS will post the new Medicare rates by Nov. 1, 2017.

Hospital stakeholders were pleased with the final rule because the agency widened the base of labs—including some hospital labs—that will be analyzed for payment trends…

“‘Excluding hospital labs from the data also excludes innovative–and expensive–laboratory tests developed at academic medical centers,” said Michelle Cooper, senior vice president and corporate responsibility officer at Catholic Health Initiatives, the nation’s second-largest not-for-profit health system.

“’Including hospital-based labs will better reflect market trends and lead to more appropriate reimbursement,” Nickels said in a statement on the final rule.” Source:  Modern Healthcare


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