Laboratory Question for the Week of August 29, 2016

Laboratory Compliance Question of the Week


My question relates to the new payment system. Will clinical labs specializing in testing drugs of abuse, HCPCS codes G0480 through G0483, be subject to the initial collection and reporting periods outlined in the final PAMA rule?


According to the Centers for Medicare & Medicaid Services, the answer is yes. If the lab meets the definition of applicable laboratory, it would be subject to the reporting requirements. However, if no data is reported, CMS would use crosswalking or gapfilling methodologies to establish a price for the test.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.