Billing Beat

2007 Annual Update for Clinical Lab Fee Schedule

January 3, 2007

Pathology services on the Physician fee schedule will not change in 2007, subsequent to Congress blocking the proposed 5% cut. The Medicare Part B fee schedule for 2007 provides a zero update.

Travel allowance to collect a specimen from a nursing home or homebound patient will also remain at the 2006 rates in 2007. For dates of service January 01, 2007 through December 2007, the fee for clinical laboratory travel code P9603 is $0.935 per mile and for code P9604 is $9.35 per flat rate trip basis.

Rates have been set for 11 new codes announced for 2007 through the cross walk process as follows:

Code Description Crosswalk Code Fee
82107 AFP-L3 fraction isoform and total AFP 83950 $89.99
83698 Lp-PLA2 83880 $47.43
83913 Molecular Diagnostics; RNA stabilization 83907 $18.66
86788 Antibody, West Nile Virus, IgM 86645 $23.54
86789 Antibody; West Nile Virus 86644 $20.11
87305 Infectious Agent Ag; Enzyme Immunoassay, Qual or Semiquant; Aspergillus 87327 $16.76
87498 Infectious Agent detection(DNA or RNA); amplified probe technique 87496 $49.04
87640 Infectious Agent detection (DNA or RNA); Staph Aureus, amplified probe technique 87651 $49.04
87641 Infectious Agent detection (DNA or RNA); Staph Aureus, Methicillin resistant, amplified probe technique 87651 $49.04
87653 Infectious Agent detection (DNA or RNA); Strep, Group B, amp probe technique 87651 $49.04
87808 Infectious agent Ag detection by immuno assay, Trichomonas vaginalis 87802 $16.76

You can access to the 2007 clinical laboratory fee schedule data file is available at the CMS web site.

Sign up for Billing Beat