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CMS Transmittals



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Editor's Welcome:

The Medicare Reform Bill was passed by Congress last week and is expected to be signed into law by the President shortly.  Key provision of this new law affecting laboratories will be discussed in today's and next week's briefings. Please continue to send us your questions and comments. We will try to respond either via email or as part of future CodeMap Compliance Briefings.

Sincerely,

Dr. Charles B. Root

2004-2008 Medicare Lab Fee Schedule Freeze

First the bad news, as an alternative to requiring co-payments for laboratory services, the recently passed Medicare Reform Bill mandates a 5-year freeze on Medicare Laboratory Fee Schedule updates effective 2004 through 2008. This means for the most part, that payment levels for existing codes will remain the same for the next five years. However, CMS still retains the authority to change reimbursement amounts for individual codes based on inherent reasonableness and other regulatory provisions. Also, remember, that all new CPT codes will be assigned new reimbursement amounts. The bottom l....

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