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CodeMap® 2021 Medicare Reimbursement Update for Labs and Pathologists::Recorded December 9, 2020

2021 Medicare Reimbursement Update for
Laboratories and Pathologists

Wednesday, December 9, 2020
2:00 - 3:15 pm (Eastern Time)

2020 included a pandemic, stay-at-home orders, a recession, and non-stop economic and stimulus legislation. Clinical laboratories have never experienced such a tumultuous and challenging period of time. Laboratories and pathologist must be prepared for changes that will persist for years to come. In our annual Medicare Reimbursement Update Webinar we will explore how recent events and upcoming regulatory and legislative changes will affect payments for clinical laboratory and pathology services in 2021 and beyond. 

PAMA Delayed: The LAB Act in 2019 and the CARES Act in 2020 both delayed the next round of reporting requirements, which now apply to hospital outreach laboratories. These legislative developments also affect the PAMA maximum payment cuts for 2021 and lingering sequestration reductions. We will thoroughly examine the next steps for PAMA and how they will impact Medicare payments and data collecting and reporting requirements for clinical laboratories. 

Significant Cuts to Pathology Reimbursement: As of now, the 2021 Medicare Physician Fee Schedule (PFS) does not look good for pathologists. Overall, CMS predicts the 2021 PFS will result on average in 9% cuts for pathology professional component reimbursement and 5% cuts for pathology technical component reimbursement. We will discuss these cuts and other deeper reductions for some high volume pathology procedures.

Increased Medicare Spending for Some High Volume Laboratory Tests: Earlier this year, the OIG published a report that Medicare spent 6% more in CY 2018 for clinical laboratory tests. This is surprising considering the fact that PAMA reduced Medicare reimbursement for more than 75% of the tests listed in the Medicare Clinical Laboratory Fee Schedule (CLFS). We will explore how Medicare continues to spend more for molecular pathology testing, automated chemistries, and high volume profiles such as the Lipid Panel and Comprehensive Metabolic Panel.  

Analysis of Reimbursement for New Codes: CMS is adding over 130 new codes to the 2021 CLFS. We will examine the resultant reimbursement rates for these new codes, which providers will use to report new infectious disease testing, including COVID-19, molecular pathology tests, MAAA tests, therapeutic drug assays, and PLA procedures. We will also discuss how CMS determined these new payment amounts. 

Price: $225.00

Price each: $225.00
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Video of Presentation and PDF Handouts.

CodeMap® is a Registered Trademark of Wheaton Partners, LLC.