Expiration of Moratorium That Allowed Independent Laboratories to Bill for the TC of Physician Pathology Services Furnished to Hospital Patients

CMS wants to notify affected providers that a Medicare payment provision Allowing Independent Laboratories to Bill for the Technical Component of Physician Pathology Services Furnished to Hospital Patients, will no longer be in effect when the provisions sunset as of December 31, 2009.

CMS continues to work with Congress on significant legislation which affects the Medicare program. We believe some or all of these provisions may be extended as part of this legislation. In the meantime, if such legislation is enacted, Medicare will notify its contractors to again process claims consistent with the extended provisions.

For services provided on or after January 1, 2010, health care providers may choose, to the extent possible, to hold their claims (that is, not submit their claims to Medicare) until it becomes clearer as to whether new legislation will be enacted to extend these provisions. If legislation is enacted, claims submission for affected services may resume. Otherwise, claims submitted with dates of service on or after January 1, 2010, will not be paid in accordance with expiring provisions because there would no longer be any statutory basis for such payment.