Calendar Year (CY) 2010 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment

This article is based on Change Request (CR) 6657 which provides instructions for the CY 2010 clinical laboratory fee schedule, mapping for new codes for clinical laboratory tests, and updates for laboratory costs subject to the reasonable charge payment.

Update to Fees

The annual update to the local clinical laboratory fees for CY 2010 is (-1.4) percent. Further, Section 145 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) adjusted the annual update by -0.5 percent through CY 2013. Therefore, the annual update for CY 2010 is (-1.9) percent.

Pricing Information

For dates of service from January 1, 2010, through December 31, 2010, the fee for clinical laboratory travel code P9603 is $1.00 per mile and the fee for clinical laboratory travel code P9604 is $10.00 per flat rate trip basis. The clinical laboratory travel codes are billable only for traveling to perform a specimen collection for either a nursing home or homebound patient.

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