Clinical Laboratory Data Reporting: Enforcement Discretion
On March 30, CMS announced that it will exercise enforcement discretion until May 30, 2017, with respect to the data reporting period for reporting applicable information under the Clinical Laboratory fee Schedule (CLFS) and the application of the Secretary’s potential assessment of civil monetary penalties for failure to report applicable information. View the announcement (PDF) and PAMA regulations page.
Effective January 1, 2018, Clinical Laboratory Fee Schedule rates will be based on weighted median private payor rates as required by the Protecting Access to Medicare Act (PAMA) of 2014. For more details, including how to prepare, collect and report data, visit PAMA Regulations.
- The CLIA Program and Medicare Laboratory Services (PDF) is designed to provide education on CLIA test methods categorized, enrollment In the CLIA program, types of certificates, certificate compliance and performance measures, and certificate of accreditation.
Billing / Payment
- Clinical Laboratory Fee Schedule
- Electronic Billing & EDI Transactions - Medicare information on electronic transactions under HIPAA
- Regulations and Notices
- Code of Federal Regulation Citations
- Negotiated Rulemaking: Coverage and Administrative Policies for Clinical Diagnostic Laboratory Services
- 66 FR 58788-58836 (PDF)
- 66 FR 58837-58886 (PDF)
- 66 FR 58887-58890 (PDF)
- Medicare Claims Processing Manual - Chapter 16 - Laboratory Services (PDF)
- Medicare Benefit Policy Manual, Chapter 15, Section 30.5 (Chiropractor Services) (PDF)
- Quarterly Provider Updates
- Clinical Labratory Improvement Amendments (CLIA)
- HIPAA - General Information
- Physician Self Referral
- Medicare National Correct Coding Initiative (NCCI) Edits
- Column 1/Column 2 Pathology and Laboratory Services -
- Mutually Exclusive Pathology and Laboratory Services -
- HCPCS - General Information
- Alpha-Numeric HCPCS
- Medicare Provider-Supplier Enrollment
- Enrollment Applications
- Conditions for Coverage (CfCs) & Conditions of Participations (CoPs)
- Information for Medicare Fee-for-Service Providers for the National Provider Identifier Standard (NPI)
How to Stay Informed
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