by Jared Staheli
July 10th, 2015
For cervical or vaginal smear clinical laboratory tests, payment is the lesser of the local fee or the national limitation amount, but not less than the national minimum payment amount (NMPA). However, in no case may payment for these tests exceed actual charges. The Part B deductible and coinsurance do not apply.
For tests performed on or after January 1, 2000, a NMPA of $14.60 is established and applies for cervical or vaginal smear clinical laboratory tests in accordance with §224 of the Balanced Budget Refinement Act (Public Law 106-113). The affected CPT laboratory test codes for the NMPA are 88142, 88143, 88144, 88145, 88147, 88148, 88150, 88152, 88153, 88154, 88164, 88165, 88166, 88167, G0123, G0143, G0144, G0145, G0147, G0148, and P3000.
The NMPA will be reviewed and updated in conjunction with the clinical laboratory fee schedule, as required. Instructions for such updates will be sent to contractors through periodic temporary instructions.