Travel Allowance Code Updated for 2017

Travel Allowance Code Updated for 2017

The Centers for Medicare & Medicaid Services has revised the 2017 travel allowance flat rate for laboratory technicians in accordance with the Internal Revenue Service.

Coverage for Travel

Medicare Part B will pay a travel allowance for a laboratory technician to draw a specimen from either a nursing home patient or homebound patient, provided the specimen collection fee is also payable. Payment for these services is made based on the Clinical Laboratory Fee Schedule.

Payment Allowances

Travel codes allow for payment either on a per mileage basis (P9603) or on a flat rate per trip basis (P9604), depending on the Medicare administrative contractor’s (MAC) preference.

P9603 Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually traveled – The allowance remains $0.535 per mile, plus an additional $0.45 per mile to cover the technician’s time and travel costs. MACs have the option of establishing a higher per mile rate if local conditions warrant it.

P9604 Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge – The updated flat rate per trip basis travel allowance is $9.85.

Coding Guidelines

The per mile travel allowance is appropriate for use where the average trip to the patients’ homes is longer than 20 miles, round trip. Payment is prorated based on the number of specimens collected per trip, and on the number of specimens drawn from non-Medicare patients in the same trip.

According to CMS, audits have shown abuse of the the per mile method, so many MACs have established local policy to pay based on a flat rate per trip basis only.

These payment rates are effective Jan. 1, 2017. MACs have until May 12, 2017, to implement these rates.

See Chapter 16, Section 60.2 of the Medicare Claims Processing Manual for complete guidance.

Source: MLN Matters Article MM9960.

Renee Dustman

Renee Dustman

Executive Editor at AAPC
Renee Dustman, BS, MACRA Proficient, is an executive editor at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. She has more than 20 years experience in print production and content management, and has worked in a variety of capacities for several publications.
Renee Dustman

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Renee Dustman, BS, MACRA Proficient, is an executive editor at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. She has more than 20 years experience in print production and content management, and has worked in a variety of capacities for several publications.

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