Question:
What is the effective date of the new laboratory payment system?
Answer:
Beginning January 1, 2018—instead of the initially planned 2017, the Centers for Medicare & Medicaid Services (CMS) will begin to use private-payer prices to set rates for clinical diagnostic laboratory tests (CDLTs) paid under the Clinical Laboratory Fee Schedule (CLFS). CMS issued the final rule on this on June 17, 2016. Before that, clinical diagnostic laboratories will be required to report the amounts paid by private insurers, and Medicare will use these private insurer rates to calculate Medicare payment rates for laboratory tests.
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