decisionhealth Newsletters, Coder Pink Sheets - 2017 Issue 12 (December)
Hundreds of lab codes expected to earn less revenue in 2018 as cuts take hold
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Article Overview
This article covers upcoming Medicare clinical laboratory fee schedule changes tied to PAMA and the CMS preliminary payment rates for 2018. It is aimed at physicians, lab owners, coders, and billing staff who need to understand how broad lab reimbursement shifts may affect office-based testing and practice revenue. The article discusses the policy background, the scope of expected rate changes, and examples of commonly billed lab tests that fall into the affected group.
Why This Topic Matters
Laboratory reimbursement changes can directly affect practice finances, especially for offices that perform high volumes of testing. Understanding the scope of CMS rate updates helps coding and billing teams anticipate revenue impact and monitor ongoing fee schedule changes.
What You Will Learn
- How Medicare laboratory payment changes are being implemented under PAMA
- Why CMS preliminary rates matter for clinical laboratory testing reimbursement
- How broad payment shifts may affect physician office labs and practice operations
- Which general categories of lab services are seeing payment decreases or increases
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Laboratory administrators
- Revenue cycle professionals
Codes Discussed
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