CMS Final Determinations Drug Testing

CMS has determined they will cover the New 2017 Presumptive Drug Testing Codes 80305-80307. They will delete G0477-G0479. CMS will continue to recognize G0480-G0483 for Definitive Drug Testing and have increased reimbursement on these codes through the reconsideration process.  The presenters at the 2016 Annual Laboratory Public Meeting and the Clinical Diagnostic Laboratory Tests Advisory Panel Meeting also raised concerns that much of the high volume of claims containing G0483 that were billed the first part of 2016 were being performed by physician office laboratories that lacked the quality control and multiple calibrations necessary for accurate results. They recommended that CMS develop a system to pay for these tests in a separate manner. As a result of this concern,  CMS has created a new HCPCS code G0659.

Source: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/Downloads/CY2017-CLFS-Codes-Final-Determinations.pdf