Question:

What is the update for local clinical laboratory fees in 2022? What is the national minimum payment amount?

Answer:

In coordination with standard regulations under Section 1833(h)(2)(A)(i) of the Act, the update to the local clinical laboratory fees is 5.1%. Effective as of January 1, 2022, this update is only applicable to pap smear tests. Understand that with pap smear tests, Section 1833(h)(7) of the Act mandates payment to be the “lesser of the local fee or the National Limitation Amount, but not less than a national minimum payment amount.” Note that pap smear test payments cannot exceed the actual charge. For 2022, the national minimum payment amount is $15.92. This value incorporates the 2021 national minimum payment amount with a 5.1% increase. Codes impacted by 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. For all other laboratory services, the annual update to payments made on a reasonable charge basis is 5.4%.

This question was answered in an edition of our Laboratory Compliance Manager. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.

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