Account for Specimen Collection Travel Expenses

New Medicare travel allowance fees for specimen collection have been updated in regard to the Clinical Laboratory Fee Schedule (CLFS). Change Request (CR) 6864 revises the 2010 payment of travel allowances, either on a per mileage basis (P9603) or on a flat rate per trip basis (P9604). The implementation date is set for April 5.

Travel allowance payment is made only when a specimen collection fee also is payable. The travel allowance accounts for the estimated travel costs of specimen collection, which includes the laboratory technician’s salary and travel expenses. Contractors determine payment on either a mileage basis or a flat rate:

  • Per Mile Travel Allowance (P9603) – This usually is used when the average trip to a patients’ homes is longer than 20 miles round trip, and is prorated if specimens are drawn from non-Medicare patients in the same trip. The federal mileage rate is $0.50 per mile plus an additional $0.45 per mile, which covers the technician’s time and travel costs. Contractors can establish a higher per mile rate than the $0.95 per mile rate when local conditions warrant it.
  • Per Flat-Rate Trip Basis Travel Allowance (P9604) – The per flat-rate trip basis travel allowance is $9.50. Because some laboratories abuse their per mileage fee by claiming travel mileage in excess of the minimum distance necessary for a laboratory technician to travel for specimen collection, according to CMS, some contractors establish local payment policy based on a flat rate basis only.

CR 6864 states, “Under either method, when one trip is made for multiple specimen collections (e.g., at a nursing home), the travel payment component is prorated based on the number of specimens collected on that trip, for both Medicare and non-Medicare patients, either at the time the claim is submitted by the laboratory or when the flat rate is set by the contractor.”

The standard mileage rate for business is based on an annual study of the fixed and variable costs for automobile operation, conducted by the Internal Revenue Service (IRS).

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