Medicare Laboratory Payment Policy

Dianne Miller Wolman, Andrea L. Kalfoglou, and Lauren LeRoy, Editors, Committee on Medicare Payment Methodology for Clinical Laboratory Services, Division of Health Care Services

• 1 Front Matter; 2 Summary; 3 1 Introduction; 4 2 Background and Environmental Trends; 5 3 Technology Trends in the Clinical Laboratory Industry; 6 4 Description of the Current Medicare Payment System and Its Historical Roots; 7 5 The Current System: How Well Does It Work?; 8 6 Alternative Payment Methodologies; 9 7 Recommendations; 10 Acronyms and Glossary; 11 Appendix A: Acknowledgments; 12 Appendix B: Medicare Clinical Laboratory Payments: The National Limitation Amount and Its Relationship to Payment Amounts; 13 Appendix C: Study of Fees and Payment System Characteristics for Clinical Laboratory Services; 14 Appendix D: Annual Volume of Laboratory Tests by Laboratory Type and Waived-Nonwaived Test Status, 1996-1998, 1999-Early 2000; 15 Appendix E: 1998 Medicare Carrier Denial Rates; 16 Appendix F: Committee Biographies