CMS Releases Preliminary Determinations for New 2015 Clinical Laboratory Fee Schedule Codes

CMS has published its preliminary payment determinations for new 2015 clinical laboratory fee schedule codes. CMS proposes to crosswalk or gap fill various new codes that will become effective January 1, 2015. Gap filled codes will be priced by individual Medicare contractors during 2015. CMS will publish these payments and eventually set rates at the median of all payments for each code to be effective January of 2016. CMS is recommending to delay pricing various individual drug testing screening codes given “the potential for overpayment when billing for each individual drug test rather than a single code that pays the same regardless of the number of drugs that are being tested for.” They appear to favor a single code that pays the same regardless of the number of drugs tested.