Question:

Do you know what the payment rate would be for CPT® codes 85025 (CBC) and 80061 (lipid panel) under the new proposed CLFS?

Answer:

Here are the preliminary rates that the Centers for Medicare & Medicaid Services (CMS) posted several weeks ago:

Codes Descriptions 2017 NLAs 2018 Payment with Cap 2019 Payment with Cap  2020 Payment with Cap
 85025 Blood count; complete (CBC), automated and automated differential WBC count  $10.66  $9.59  $8.63  $7.77
 80061  Lipid panel  $0.00  $11.23  $11.23  $11.23

CPT® is a registered trademark of the American Medical Association.


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

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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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