Laboratory Question for the Week of July 8, 2019

Laboratory Compliance Question of the Week


What information is included in the private-payer claims data for (PAMA) reporting?


The following applicable information should be part of the private-payer claims data under the Protecting Access to Medicare Act of 2014 (PAMA):

  • Laboratory tests subject to the data-collection and reporting requirements
  • Final amount paid by a private payer for laboratory tests after all private-payer price concessions are applied
  • Payments from secondary insurance payers
  • Any patient cost-sharing amounts, if applicable
  • Multiple payment rates for the same test.

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