CMS to host call for clinical diagnostic laboratories to collect and report private payor rates

CMS will be hosting a call on Tuesday, January 22 1:00 – 2:00 p.m. CST for clinical diagnostic laboratories, including physician offices laboratories and hospital outreach laboratories that bill using a 14X TOB are required to report laboratory test Healthcare Common Procedure Coding System (HCPCS) codes, associated private payor rates, and volume data if they:

  • Have more than $12,500 in Medicare revenues from laboratory services on the Clinical Laboratory Fee Schedule (CLFS), and
  • Receive more than 50 percent of their Medicare revenues from CLFS and physician fee schedule services during a data collection period

This call will provide a refresher on how to collect and submit required data. CMS will use this data to set Medicare payment rates effective January 1, 2021.

To register for the conference call and Medicare Learning Network events.

A question and answer session follows the presentation; however, you may email questions in advance to CLFS_Inquiries@cms.hhs.gov with “January 22 Call” in the subject line. These questions may be addressed during the call or used for other materials following the call.  For more information, visit the PAMA Regulations webpage.