Tag: PAMA

CMS solicits comments on specimen collection codes and proposes conforming regulatory changes for PAMA in CY 2021 MPFS Proposed Rule

In the CY 2021 MPFS Proposed Rule, CMS solicited comments on whether the two specimen collection codes (G2023 and G2024), established during the COVID-19 PHE, should be deleted or should remain after the PHE has ended. These codes were created for in...

Congress passes CARES Act

On March 27, 2020, the President signed the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act represents the third largest stimulus bill passed by Congress in response to the COVID-19 pandemic and with $2 trillion in allocatio...

CMS issues Transmittal on Revised Data Reporting Period under PAMA

Following the passage of the LAB Act, CMS issued a transmittal that specifies the new data reporting period for Clinical Diagnostic Laboratory Tests (CDLTs) that are not Advanced Diagnostic Laboratory Tests (ADLTs) (delayed until January 1 – March ...

Congress Passes the LAB Act

On December 19, Congress passed the Laboratory Access for Beneficiaries (LAB) Act as part of an end-of-year spending package signed into law by the President on December 20. The LAB Act has been a priority for a number of stakeholders in the laborato...

CMS Publishes Application for new “U” codes for Laboratory Tests

CMS has published its application for new “U” codes for advanced diagnostic laboratory tests (ADLTs) and FDA-cleared or approved clinical diagnostic laboratory tests (CDLTs). These new “U” codes are intended to describe a single test. Reviews...

CMS Responds to Senator Grassley’s Inquiry on PAMA implementation

Senator Grassley quizzes CMS about PAMA implementation

CMS Releases Laboratory Data Collection FAQ

CMS Releases CY 2019 CLFS Payment Rates

The Centers for Medicare and Medicaid Services has released the final CY 2019 payment rates for clinical diagnostic services along with supporting instructional materials.  These rates are effective for claims with dates of service on or after Janua...

Medicare Payments for Clinical Diagnostic Laboratory Tests in 2017: Year 4 of Baseline Data

On September 20, the Office of the Inspector General (OIG) released the fourth in a series of data briefs looking at Medicare spending under the Clinical Laboratory Fee Schedule.  This report evaluates Medicare spending in 2017, the final year befor...

ACLA Files Lawsuit Challenging CMS Implementation of PAMA Section 216

On Monday December 11, the American Clinical Laboratory Association (ACLA) filed a legal challenge to CMS’s implementation of the revised Clinical Laboratory Fee Schedule (CLFS) required under Section 216 of the Protecting Access to Medicare Act ...

CY 2017 Medicare OPPS – Proposed Rule (CMS-1656-P)

Medicare Clinical Diagnostic Laboratory Tests Payment System – Final Rule (CMS-1621-F)

Medicare Clinical Diagnostic Laboratory Tests Payment System – Proposed Rule (CMS-1621-P)

Breaking: CMS Releases Anticipated PAMA 216 Regulations

The Centers for Medicare and Medicaid Services today posted the long-awaited proposed rule to implement section 216 of the Protecting Access to Medicare Act, which when finalized, will revamp how CMS determines payment amounts for laboratory se...

Protecting Access to Medicare Act (PL 113-93)