Laboratory Question for the Week of January 23, 2017

Laboratory Compliance Question of the Week

Question:

Which Pap Test codes are included in the Medicare national payment rate?

Answer:

As required by law, payment for a cervical or vaginal smear test (Pap smear) must be the lesser of the local fee or the national limitation amount (NLA) but not less than a national +minimum payment amount, which for 2017 is $14.49. Payment for these tests may not exceed the actual charge.

The national minimum payment amount applies to the following codes: 88142, 88143, 88147, 88148, 88150, 88152, 88153, 88154, 88164, 88165, 88166, 88167, 88174, 88175, G0123, G0143, G0144, G0145, G0147, G0148, G0476, and P3000.

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.