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Question:
Which Pap Test codes are included in the Medicare national payment rate?
Answer:
As required by law, payment for a cervical or vaginal smear test (Pap smear) must be the lesser of the local fee or the national limitation amount (NLA) but not less than a national +minimum payment amount, which for 2017 is $14.49. Payment for these tests may not exceed the actual charge.
The national minimum payment amount applies to the following codes: 88142, 88143, 88147, 88148, 88150, 88152, 88153, 88154, 88164, 88165, 88166, 88167, 88174, 88175, G0123, G0143, G0144, G0145, G0147, G0148, G0476, and P3000.
CPT® copyright 2023 American Medical Association (AMA). All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
CPT is a registered trademark of the American Medical Association.
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