Medicare will implement a redefined Type of Bill (TOB) 14x to avoid overpayment for lab services furnished to non-patients. Any hospital (including a Critical Access Hospital (CAH)) receiving such specimens is to bill for the lab test on a TOB 14x.
Lab services performed for non-patients by a CAH or a hospital subject to a state of Maryland waiver, will be paid on the Part B clinical diagnostic lab fee schedule.
Since the definition of 14x was changed, in the early 1990s, to be for â€œall referred diagnostic servicesâ€, CMS lost the ability to differentiate between the lab specimens of outpatients and of non-patients. Consequently, TOB 14x could not be used to drive differential payment. The change is being implement due to the need to distinguish between outpatients and non-patients for certain pathology tests, and an upcoming demonstration project that will only apply to non-patients.