Quarterly Update for Clinical Laboratory Fee Schedule (CLFS) and Laboratory Services Subject to Reasonable Charge Payment

New Codes Effective July 1, 2022 Proprietary Laboratory Analysis (PLAs).

The listed new codes were added to the national Healthcare Common Procedure Coding System (HCPCS) file with an effective date of July 1, 2022 and do not need to be manually added to the HCPCS files by the MACs. However, these new codes are contractor-priced (where applicable) until they are nationally priced and undergo the CLFS annual payment determination process in accordance with the Social Security Act § 1833(h)(8), § 1834A(c) and § 1834(A)(f). MACs shall only price PLA codes for laboratories within their jurisdiction. The table includes the laboratory, long descriptor, short descriptor, and type of service (TOS) of each new code. In addition, the following HCPCS codes were discontinued on September 30, 2021, and are to be removed from the CLFS: 0139U (short descriptor, Neuro austm meas 6 c metablt), and 0168U (short descriptor, Ftl aneuploidy dna seq alys).

Source: https://www.cms.gov/files/document/r11398cp.pdf#page=7