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PLA Codes

Laboratory Fee Schedule

2019
2018

Physician Fee Schedule

2019
2018

OPPS Fee Schedule

2019
2018

ASC Fee Schedule

2019
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APC Codes

2019
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DRG Codes

2019
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ASP Drug Pricing Files

January 2019
October 2018


CMS Transmittals




Editor's Welcome

This week we will review coding and payment policy for CLIA waived tests. Also, please note that CMS has corrected the travel allowance to collect specimens (HCPCS codes P9612 and P9615) from the previously stated $0.835/mile and $8.35 per one way trip to $0.825 and $8.25 respectively. As always, feel free to send us questions or suggestions for future Compliance Briefings.

Sincerely,

Charles Root, Ph.D.

Medicare Reimbursement for CLIA Waived Tests

All laboratories must have one of the following CLIA certificates to legally perform clinical laboratory testing on specimens obtained from individuals in the United States.

Certificate of Waiver
Certificate for Provider Performed Microscopy (PPM) Procedures,
Certificate of Registration,
Certificate of Compliance, or
Certificate of Accreditation

Medicare edits all laboratory claims to ensure the provider submitting the claim has an appropriate CLIA certificate. A CLIA certificate number must be included on each laboratory claim.  Laboratories with a certific....

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