CMS to Tackle Lab Payments Codes in Pair of Public Meetings

The Medicare advisory panel will provide input to CMS on setting payment rates for new clinical diagnostic laboratory tests, including whether to use "crosswalking" or "gapfilling" processes to determine payment for a specific new test. Crosswalking is used when a new CDLT is comparable to an existing test; gapfilling is used when no comparable CDLT exists. The panel also will give advice on the factors used in determining coverage and payment processes for new tests.  

  • CMS will hold its annual public meeting on June 24 to hear comments on the appropriate basis for setting payment amounts for new and revised Healthcare Common Procedure Coding System codes being considered for payment under the Clinical Laboratory Fee Schedule (CLFS) for 2020.
  • At the meeting, the Medicare advisory panel on Clinical Diagnostic Laboratory Tests will gather information and question presenters.
  • The advisory panel also set its own public meeting for July 22-23 to focus on the discussion and recommendations for test codes that emerge from the June 24 meeting as well as other issues. Registration to attend the panel meeting in person may be completed online between April 8 and July 1.



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