MLN CLFS Fact Sheet Updated for 2011

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  • April 1, 2011
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The Centers for Medicare & Medicaid Services (CMS) has updated its Medicare Learning Network (MLN) payment system fact sheet for the Clinical Laboratory Fee Schedule (CLFS). In this fact sheet you will find background information and coverage of clinical laboratory services and payment rates updated for 2011.

Of particular importance is the list of currently covered preventive screening services and the information regarding how 2011 payment rates are set.
To date, covered preventive screening services for qualified Medicare beneficiaries include:

  • Cardiovascular screening blood tests
  • Screening Pap tests
  • Colorectal cancer screening tests
  • Prostate-specific antigen screening blood tests
  • Diabetes screening tests
  • HIV infection screening tests (with dates of service on or after Dec. 8, 2009)

For 2011, the CLFS is -1.75 percent. The Patient Protection and Affordable Care Act (PPACA) re-instituted reasonable cost payment for clinical lab tests performed by hospitals with fewer than 50 beds in qualified rural areas as part of their outpatient services for cost reporting periods beginning on or after July 1, 2010 through June 30, 2011.
Cervical or vaginal smear tests (Pap smears) are paid the lesser of the local fee or the national limitation amount, but not less than the national minimum payment amount. The 2011 national minimum payment amount for cervical or vaginal smears is $14.87, which includes the -1.75 percent annual update.
Download the MLN publication for complete details.


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