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Issue Number - Name
0087 - Labs Subject to Part B Consolidated Billing - ESRD
Review Type
Automated
Claim Type
Professional Services (Physician/Non-Physician; Outpatient Hospital)
Region and State
RAC 1-4
All States
Date Approved
2018-02-13

Description

Certain laboratory services and limited drugs and supplies will be subject to Part B consolidated billing and will no longer be separately payable when provided for ESRD beneficiaries by providers other than the renal dialysis facility. Claims will be recouped for Labs subject to ESRD Consolidated Billing that are bundled into the facility payment.

Affected Code(s)

  • Labs subject to ESRD Consolidated Billing, (CY 2014-2017),  

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ESRDpayment/Consolidated_Billing.html

Applicable Policy References