Clinical Laboratory Fee Schedule Update to Fees

For a pap smear test, Section 1833(h)(7) of the Social Security Act (the Act) requires payment to be the lesser of the local fee or the national limitation amount, but not less than a national minimum payment amount. Payment for pap smear tests also can’t exceed the actual charge. The CY 2023 national minimum payment amount is $17.31, an increase of 8.7%. 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 we make on a reasonable charge basis for all other laboratory services is the CPI-U, which for CY 2023 is 9.1% (See 42 CFR 405.509(b)(1)).

MM: 13023

CR Transmittal #: R11733CP

Source: https://www.cms.gov/files/document/mm13023-clinical-laboratory-fee-schedule-cy-2023-annual-update.pdf