by Jared Staheli
July 10th, 2015
Clinical laboratory tests are covered under Medicare if they are reasonable and necessary for the diagnosis or treatment of an illness or injury. Because of the numerous technological advances and innovations in the clinical laboratory field and the increased availability of automated testing equipment, no distinction is generally made in determining payment for individual tests because of either (1) the sites where the service is performed, or (2) the method of the testing process used, whether manual or automated. Whether the test is actually performed manually or with automated equipment, the services are considered similar and the payment is the same.
However, where groups of tests that are billed individually may be done as a panel or profile, a determination must be made about whether payment should be made at the individual rate or at the panel or profile rate.