Calendar Year (CY) 2022 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment

CLFS Update to Fees For a Pap smear test, Section 1833(h)(7) of the Social Security Act (the Act) requires payment at the lesser of the local fee or the National Limitation Amount, but not less than a national minimum payment amount. However, for Pap smear tests, payment may also not exceed the actual charge. The CY 2022 national minimum payment amount is $15.92 (This value reflects the CY 2021 national minimum payment with a 5.1% increase or $15.15 times 1.051.) The affected codes for the national minimum payment amount are: 88142, 88143, 88147, 88148, 88150, 88152, 88153, 88164, 88165, 88166, 88167, 88174, 88175, G0123, G0143, G0144, G0145, G0147, G0148, Q0111, Q0115, and P3000.

The annual update to payments made on a reasonable charge basis for all other laboratory services for CY 2022 is 5.4% (See 42 CFR 405.509(b)(1)). Part B deductible and coinsurance don’t apply for services paid under the CLFS. CR-12558

 

Source: https://www.cms.gov/files/document/mm12558-calendar-year-cy-2022-annual-update-clinical-laboratory-fee-schedule-and-laboratory-services.pdf