Clinical Lab Fee Schedule Update Released

The 2011 Clinical Lab Fee Schedule annual update has been released. The update, effective Jan. 1, 2011, includes 16 new codes and 1,188 modified codes. Under the new fee schedule, local clinical laboratory rates are reduced by 1.75 percent while payments for reasonable charges for all other lab services goes up 1.1 percent.
The 2011 national minimum payment amount is 14.87 percent ($15.13 minus the 1.75 percent update for 2011). The affected CPT® and HCPCS Level II codes for the national minimum payment amount are shown in the following table:

The per mile travel allowance (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 travelled) is 95 cents per mile and the per flat-rate trip basis travel allowance (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) is $9.50.
The 2011 Clinical Laboratory Fee Schedule data file is available on the Centers for Medicare & Medicaid Services (CMS) website.
Source: MLN Matters MM6991

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