Physician Office CLIA Lab Billing Questions


Vancouver, WA
Best answers
Our office is setting up a physician office CLIA lab and I had several questions about billing for this that I'm hoping that someone can shed some light on. The lab will have a single lab technician that will be performing the following tests: 88305-TC, G0416-TC, 88112-TC, 84270, 84403, 84153, 54154, 86316. I'm a little confused as to how to bill for the technician's services, as she does not have her own NPI number. It is my understanding that the lab istelf, once CLIA certified, will have its own NPI number? Do we use that number as the servicing, rendering and supervising provider? Any help anyone could provide in how to bill for these services would be greatly appreciated...


True Blue
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The lab will not receive a separate NPI - the CLIA certification just certifies that the lab meets the quality standards required to be eligible to perform these services. If this lab is in a physician office, it will not change how you bill. These are technical services, not professional, so will need to be performed under physician supervision and should be billed under the credentials of the physician who is on site when they are performed.