New Medicare travel allowance fees for specimen collection have been updated in regard to the Clinical Laboratory Fee Schedule (CLFS). Change Request (CR) 6864 revises the 2010 payment of travel allowances, either on a per mileage basis (P9603) or on a flat rate per trip basis (P9604). The implementation date is set for April 5.
April 5th, 2010
The Centers for Medicare & Medicaid Services (CMS) recently issued a Medicare Learning Network (MLN) article to clarify how clinical diagnostic laboratories should bill for certain types of tests covered by Medicare and paid under the Clinical Laboratory Fee Schedule (CLFS).
Specifically, MLN SE1001 addresses how labs should presently bill new 2010 HCPCS Level II codes G0430 and G0431 and existing CPT® codes 80100 and 80101.
The current descriptions for said codes are:
- 80100 Drug screen, qualitative; multiple drug classes chromatographic method, each procedure
- G0430 Drug screen, qualitative; multiple drug classes other than chromatographic method, each procedure
- 80101 Drug screen, qualitative; single drug class method (eg, immunoassay, enzyme assay), each drug class
- 80101QW Drug screen, qualitative; single drug class method (eg, immunoassay, enzyme assay), each drug class – CLIA waived test
- G0431 Drug screen, qualitative; single drug class method (eg, immunoassay, enzyme assay), each drug class
From Jan. 1 to March 31, labs should report 80100 for qualitative drug screening tests for multiple drug classes when using chromatographic methods and G0430 when not using chromatographic methods.
HCPCS Level II G0431 is a direct replacement for CPT® code 80101. Although CMS is delaying implementation of G0431 until April 1, the agency instructs labs who do not require a Clinical Laboratory Improvement Amendments (CLIA) certificate of waiver to report qualitative drug screening tests for a single class of drugs, regardless of testing methodology, using G0431. Presently, labs requiring a CLIA certificate of waiver should continue to bill 80101QW.
January 18th, 2010
Clinical laboratories submitting claims for services provided to Medicare beneficiaries are in for a bit of a pay raise this year. The Centers for Medicare & Medicaid Services (CMS) has revised the Medicare 2009 travel allowance fees for specimen collection.
Paid under the Clinical Laboratory Fee Schedule, Medicare Part B covers the estimated travel costs for specimen collection (including the laboratory technician’s salary and travel expenses) on a flat-rate or per mile basis when a specimen collection fee is also payable.
Some Medicare contractors have established local policy to pay based on a flat-rate trip basis only. Remember to check your local Medicare contractor’s payment policy before submitting claims of this nature.
For 2009, the per flat-rate trip basis travel allowance (P9604) is $10.00 (a 5 cent increase from 2008), and, in situations where the average round trip to patients’ homes is more than 20 miles, the per mile travel allowance (P9603) is $1.00 (also a 5 cent increase from 2008).
Medicare contractors have the option of establishing a higher per mile rate in excess of the minimum of $1.00 per mile if local conditions warrant it.
To receive the travel allowance fee payment update for processed claims submitted between Jan. 1 (when the revised rates became effective) and Oct. 5 (when the new rates will be implemented) contact your local Medicare contractor. Contractors will not retroactively pay claims unless you do.
Read CMS Transmittal 1790, Change Request 6524, issued Aug. 7, for complete details.
August 12th, 2009