CMS’ Proposed Provision Ends Payment to Independent Laboratories for TC of Certain Physician Pathology Services Beginning CY 2012

Section 105 of the Medicare and Medicaid Extenders Act of 2010 (“MMEA”) extended the payment to independent laboratories for the technical component (“TC”) of certain physician pathology services through calendar year (“CY”) 2011 only. In line with section 105, the Centers for Medicare & Medicaid Services’ (“CMS”) Proposed Physician Fee Schedule for CY 2012 revises 42 C.F.R. §415.130(d). The revised provision would state that “for services furnished after December 31, 2011, an independent laboratory may not bill the Medicare contractor for the TC of physician pathology services furnished to a hospital inpatient or outpatient.” The provision would be implemented effective for TC services provided on or after January 1, 2012.

For more information regarding CMS’ Proposed Physician Fee Schedule for CY 2012 or professional assistance navigating the ever-evolving healthcare landscape, please contact Adrienne Dresevic, Esq. or Carey F. Kalmowitz, Esq. at (248) 996-8510 or (212) 734-0128, or visit the HLP website.