Clinical Laboratory Fee Schedule & Laboratory Services Subject to Reasonable Charge Payment: Quarterly Update 4/1/2023

New Codes Effective April 1, 2023 Proprietary Laboratory Analysis (PLA) See the tab “New Codes” of the table attached to CR 13082.  New codes added to the national HCPCS file with an effective date of April 1, 2023. These new codes are MACpriced (where applicable) until they’re nationally priced. MACs will only price PLA codes for laboratories in their jurisdiction. The table includes the laboratory, long descriptor, short descriptor, and Type of Service (TOS) of each new code.

The following HCPCS codes are discontinued on April 1, 2023, and will be removed from CLFS:

• 0324U (Oncology (ovarian), spheroid cell culture, 4-drug panel (carboplatin, doxorubicin, gemcitabine, paclitaxel), tumor chemotherapy response prediction for each drug)

• 0325U (Oncology (ovarian), spheroid cell culture, poly (ADPribose) polymerase (PARP) inhibitors (niraparib, olaparib, rucaparib, velparib), tumor response prediction for each drug)