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CodeMap® 06/03/2021: Medicare Direct Billing Rules

CodeMap® Compliance Briefing: June 3, 2021


Editor's Welcome:

Even as the pandemic resides, we continue to receive inquiries about laboratory practices that have developed as a result of the strange and disruptive period caused by COVID-19. Recently, we have received multiple email inquiries concerning Medicare's direct billing rules. Many of these inquiries are from laboratories, which were forced to send out increased volumes of testing to outside, reference labs due to labor shortages, stay-at-home orders, and/or supply chain disruptions. Considering these inquiries, we decided that now is a good time to revisit Medicare's direct billing rules, in particular, the 70/30 rule. We also chose to discuss how the 70/30 rule applies to tests and procedures described by MAAA and....

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